Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland最新文献

英文中文

Distant lymph node metastasis in differentiated thyroid cancer: A population-based cohort study 分化型甲状腺癌的远处淋巴结转移：基于人群的队列研究

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-02-01 DOI: 10.1016/j.surge.2024.07.004

Ying Ding , Ruixin Zhou

Background

Cervical lymph node metastasis (LNM) is the most common clinical event in patients with differentiated thyroid cancer (DTC). However, the incidence, pattern, treatment, and prognosis of distant LNM are yet to be reported.

Methods

DTC patients with distant LNM were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2016 and 2020. Multivariate models and propensity score matching (PSM) were used to account for the effects of covariates. The Kaplan-Meier method was used to evaluate the overall survival (OS) and cancer-specific survival (CSS). A nomogram was established to predict the probability of distant LNM in DTC patients, with calibration and Receiver Operating Characteristic (ROC) curves utilized to validate the nomogram's accuracy.

Results

Of the 42,339 DTC patients screened, 100 (0.24 %) patients presented with distant LNM. Risk factors including age, sex, T stage, N stage, bone metastasis, brain metastasis, and lung metastasis were included in the nomogram to predict the probability of distant LNM. The calibration curve of the nomogram was close to the ideal diagonal line and the area under the curve (AUC) of the ROC curve is 0.953. Distant LNM showed a worse prognosis after adjusting for confounders compared with non-distant LNM (P < 0.05). Remarkably, radioactive iodine (RAI) therapy did not improve the OS and CSS in DTC patients with distant LNM in the overall or PSM cohort.

Conclusions

Distant LNM presents as a comparatively rare but grave condition with a substantial negative impact on prognosis in patients with DTC. Identified risk factors of distant LNM are older age, male, advanced T stage and N stage, bone metastasis, brain metastasis, and lung metastasis. Remarkably, the current RAI therapy does not appear to significantly improve the survival outcome of DTC patients with distant LNM.

背景：颈淋巴结转移（LNM）是分化型甲状腺癌（DTC）患者最常见的临床症状。然而，关于远处淋巴结转移的发生率、模式、治疗和预后尚无报道：方法：从监测、流行病学和最终结果（SEER）数据库中找出2016年至2020年间患有远处LNM的DTC患者。采用多变量模型和倾向得分匹配（PSM）来考虑协变量的影响。采用卡普兰-梅耶法评估总生存期（OS）和癌症特异性生存期（CSS）。建立了预测 DTC 患者远处 LNM 概率的提名图，并利用校准和接收者操作特征曲线（ROC）验证提名图的准确性：在接受筛查的 42,339 名 DTC 患者中，有 100 人（0.24%）出现远处 LNM。包括年龄、性别、T期、N期、骨转移、脑转移和肺转移在内的风险因素被纳入提名图，以预测远处LNM的概率。提名图的校准曲线接近理想对角线，ROC 曲线的曲线下面积（AUC）为 0.953。与非远端 LNM 相比，调整混杂因素后，远端 LNM 的预后更差（P 结论：远端 LNM 的预后更差：远处 LNM 比较罕见，但病情严重，对 DTC 患者的预后有很大的负面影响。已确定的远处淋巴结转移风险因素包括年龄较大、男性、T 期和 N 期晚期、骨转移、脑转移和肺转移。值得注意的是，目前的 RAI 治疗似乎并不能明显改善伴有远处 LNM 的 DTC 患者的生存预后。

{"title":"Distant lymph node metastasis in differentiated thyroid cancer: A population-based cohort study","authors":"Ying Ding , Ruixin Zhou","doi":"10.1016/j.surge.2024.07.004","DOIUrl":"10.1016/j.surge.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><div><span>Cervical lymph node metastasis (LNM) is the most common clinical event in patients with </span>differentiated thyroid cancer<span> (DTC). However, the incidence, pattern, treatment, and prognosis of distant LNM are yet to be reported.</span></div></div><div><h3>Methods</h3><div><span>DTC patients with distant LNM were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2016 and 2020. Multivariate models and </span>propensity score matching<span> (PSM) were used to account for the effects of covariates. The Kaplan-Meier method was used to evaluate the overall survival (OS) and cancer-specific survival (CSS). A nomogram was established to predict the probability of distant LNM in DTC patients, with calibration and Receiver Operating Characteristic (ROC) curves utilized to validate the nomogram's accuracy.</span></div></div><div><h3>Results</h3><div><span><span>Of the 42,339 DTC patients screened, 100 (0.24 %) patients presented with distant LNM. Risk factors including age, sex, T stage, N stage, bone metastasis<span>, brain metastasis, and </span></span>lung metastasis were included in the nomogram to predict the probability of distant LNM. The calibration curve of the nomogram was close to the ideal diagonal line and the area under the curve (AUC) of the ROC curve is 0.953. Distant LNM showed a worse prognosis after adjusting for confounders compared with non-distant LNM (</span><em>P</em><span> < 0.05). Remarkably, radioactive iodine (RAI) therapy did not improve the OS and CSS in DTC patients with distant LNM in the overall or PSM cohort.</span></div></div><div><h3>Conclusions</h3><div><span>Distant LNM presents as a comparatively rare but grave condition with a substantial negative impact on prognosis in patients with DTC. Identified risk factors of distant LNM are older age, male, advanced T stage and N stage, bone metastasis<span>, brain metastasis, and </span></span>lung metastasis. Remarkably, the current RAI therapy does not appear to significantly improve the survival outcome of DTC patients with distant LNM.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages 38-44"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Talent Drain in Neurosurgery 神经外科人才流失。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-02-01 DOI: 10.1016/j.surge.2024.12.005

Lia Ubillus Peña , Yaritza La Torre , Carlos Gonzales Fernández , Gonzalo Jair Callahuanca-Flores , Irving Gabriel Calisaya-Madariaga

引用次数: 0

Use of the contour ® curved cutter stapler device for rectal transection during robotic assisted surgery 在机器人辅助手术中使用轮廓 ® 弯刀订书机装置进行直肠横切。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-02-01 DOI: 10.1016/j.surge.2024.11.007

Fraser Sneddon, Colin H. Richards, Raymond Oliphant

Background

Rectal division during minimally invasive surgery including robotic assisted surgery remains challenging, with current techniques often requiring multiple stapler firings to achieve effective transection.

Aims

We propose a novel technique which allows the use of a Contour® Curved Cutter Stapler to achieve rectal division during robotic assisted surgery.

Methods

The stapler is inserted through the routinely made pfannenstiel incision and a glove, over an Alexis® port used to create an airtight seal.

Conclusion

This simple technique enables reliable perpendicular single stapler firing to achieve rectal transection during colorectal robotic assisted surgery without the requirement for any further incisions.

背景：在包括机器人辅助手术在内的微创手术中进行直肠分割仍然具有挑战性，目前的技术通常需要多次发射订书机才能实现有效横断。目的：我们提出了一种新技术，允许在机器人辅助手术中使用 Contour® 弯刀订书机实现直肠分割：方法：通过常规的pfannenstiel切口和手套将订书机插入Alexis®端口，以形成气密性密封：结论：这项简单的技术可在结肠直肠机器人辅助手术中实现可靠的垂直单订书机发射，以实现直肠横断，而无需任何进一步的切口。

引用次数: 0

Are all surgeons the same? Assessing emotional intelligence and gender differences amongst surgical residency applicants in Ireland 外科医生都一样吗？评估爱尔兰外科住院实习申请者的情商和性别差异。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-02-01 DOI: 10.1016/j.surge.2024.08.007

F. O’Kelly , B.R. O’Connor , E. O’Dowd , K. Neylon , D.H. Shackleton , K. Sheehan , E. Cotter , R.M. Conroy , D. O’Keeffe , B.B. McGuire , O. Traynor , E.M. Doherty

引用次数: 0

The rise and fall of “marginal gains” – Lessons for surgery? “边际收益”的兴衰——外科手术的教训？

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-02-01 DOI: 10.1016/j.surge.2024.12.004

Connor Boyle, Calum Arthur, Steven Yule

引用次数: 0

The impact of inadequate disclosure and patient recall on the consent process in neurosurgery: A systematic literature review 不充分的信息披露和患者回忆对神经外科同意过程的影响：系统的文献综述。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-02-01 DOI: 10.1016/j.surge.2024.11.009

Ashraf Elmahdi, David Smith

Background

The informed consent process in neurosurgery aims to uphold patient autonomy and provide comprehensive information for decision-making. However, gaps in communication and understanding between patients and surgeons persist. This systematic review examined the impact of consent on neurosurgical practice, exploring the effectiveness of different consent approaches.

Methods

A comprehensive search of databases and relevant sources identified twenty-eight studies for inclusion. Prospective and retrospective studies were assessed to examine the effect of consent on neurosurgical practice. Data collection and analysis involved independent reviewers assessing eligibility, study quality, and risk of bias. Findings from the included studies were used to write the review.

Main results

Randomized controlled trials specific to the impact of consent in neurosurgery needed to be included. Nevertheless, the reviewed twenty-nine studies revealed a significant risk of litigation due to inadequate information provision. Neurosurgeons' adherence to the standard of competent peers was identified as crucial in bridging the gap between desired and actual patient-surgeon interactions.

Authors conclusions

This review underscores the need to address communication gaps between patients and surgeons within the informed consent process in neurosurgery. Neurosurgeons must strive to meet the standard of competent peers and implement effective consent strategies involving multiple modalities. Enhancing communication and patient comprehension can mitigate potential litigation risks, ensuring better patient-centred care and shared decision-making in neurosurgical practice.

背景：神经外科的知情同意过程旨在维护患者的自主权，并为决策提供全面的信息。然而，患者和外科医生之间的沟通和理解仍然存在差距。本系统综述检查了同意对神经外科实践的影响，探讨了不同同意方法的有效性。方法：综合检索数据库和相关来源，确定了28项研究纳入。评估前瞻性和回顾性研究，以检查同意对神经外科实践的影响。数据收集和分析由独立的审稿人评估合格性、研究质量和偏倚风险。纳入研究的结果被用于撰写综述。主要结果：需要纳入针对同意对神经外科影响的随机对照试验。然而，经审查的29项研究显示，由于资料提供不足，存在重大的诉讼风险。神经外科医生对有能力的同行的标准的坚持被认为是在弥合期望和实际的患者-外科医生互动之间的差距的关键。作者的结论：这篇综述强调了在神经外科的知情同意过程中，需要解决患者和外科医生之间的沟通差距。神经外科医生必须努力达到有能力的同行的标准，并实施有效的同意策略，包括多种方式。加强沟通和患者理解可以降低潜在的诉讼风险，确保更好的以患者为中心的护理和共享决策在神经外科实践。

{"title":"The impact of inadequate disclosure and patient recall on the consent process in neurosurgery: A systematic literature review","authors":"Ashraf Elmahdi, David Smith","doi":"10.1016/j.surge.2024.11.009","DOIUrl":"10.1016/j.surge.2024.11.009","url":null,"abstract":"<div><h3>Background</h3><div>The informed consent process in neurosurgery aims to uphold patient autonomy and provide comprehensive information for decision-making. However, gaps in communication and understanding between patients and surgeons persist. This systematic review examined the impact of consent on neurosurgical practice, exploring the effectiveness of different consent approaches.</div></div><div><h3>Methods</h3><div>A comprehensive search of databases and relevant sources identified twenty-eight studies for inclusion. Prospective and retrospective studies were assessed to examine the effect of consent on neurosurgical practice. Data collection and analysis involved independent reviewers assessing eligibility, study quality, and risk of bias. Findings from the included studies were used to write the review.</div></div><div><h3>Main results</h3><div>Randomized controlled trials specific to the impact of consent in neurosurgery needed to be included. Nevertheless, the reviewed twenty-nine studies revealed a significant risk of litigation due to inadequate information provision. Neurosurgeons' adherence to the standard of competent peers was identified as crucial in bridging the gap between desired and actual patient-surgeon interactions.</div></div><div><h3>Authors conclusions</h3><div>This review underscores the need to address communication gaps between patients and surgeons within the informed consent process in neurosurgery. Neurosurgeons must strive to meet the standard of competent peers and implement effective consent strategies involving multiple modalities. Enhancing communication and patient comprehension can mitigate potential litigation risks, ensuring better patient-centred care and shared decision-making in neurosurgical practice.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages 45-51"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A boost to concentration or a distracting noise? A systematic review of surgeon and anaesthetist perspectives of the benefit of intra-operative music 是提高注意力还是分散注意力的噪音？系统回顾外科医生和麻醉师对术中音乐益处的看法。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-02-01 DOI: 10.1016/j.surge.2024.11.002

K. Onuoha , D. Jones , W. Eardley

Background

The surgical team should be as harmonious and focussed as possible in the operating theatre. Whilst there is evidence of benefit for the use of music in the perioperative period for patient, little exists to inform of impact on those doing the surgery or anaesthesia. This review focuses on the perspectives of surgeons and anaesthetists, their views and opinions on the effect and impact of music during surgery.

Methods

A systematic review was conducted using narrative synthesis. The PRISMA guidelines were followed with the use of PICO and PRISMA guided search strategy. PubMed, CINAHL and Medline were searched but filtered to only published English language papers.

Results

Of 329 papers identified 42 duplicates were removed. 287 were screened; of which 276 were excluded and 11 sought for retrieval. Of these, 8 were excluded for wrong population or study design, leaving 3 for analysis.

Narrative synthesis revealed three themes to guide discussion: (1) Views of surgeons and anaesthetists and the effect on music; (2) effect of music on other staff members; and (3) differences in music choices and balance of power.

Conclusion

Music has an overall beneficial effect on surgeons and anaesthetists, especially with regards improved concentration. As an intervention, it has global generalisability and requires little resource. Investigation across different surgical specialities and use of flexible control models in terms of choosing music is a natural subsequent research question.

背景：在手术室中，手术团队应尽可能保持和谐并集中精力。虽然有证据表明在围手术期使用音乐对病人有益，但很少有资料能说明音乐对手术或麻醉人员的影响。本综述侧重于外科医生和麻醉师的观点，以及他们对手术期间音乐的效果和影响的看法和意见：方法：采用叙事综合法进行系统综述。方法：采用叙事综合法进行了系统综述，并遵循了 PRISMA 指南，使用了 PICO 和 PRISMA 引导的搜索策略。对 PubMed、CINAHL 和 Medline 进行了检索，但只筛选了已发表的英文论文：在确定的 329 篇论文中，删除了 42 篇重复论文。筛选出 287 篇，其中 276 篇被排除，11 篇需要检索。其中 8 篇因研究对象或研究设计错误而被排除，剩下 3 篇用于分析。叙事综述揭示了引导讨论的三个主题：(1) 外科医生和麻醉师的观点及对音乐的影响；(2) 音乐对其他工作人员的影响；(3) 音乐选择的差异和权力平衡：音乐对外科医生和麻醉师总体上有好处，尤其是在提高注意力方面。作为一种干预措施，它具有全球普遍性，而且所需资源很少。对不同外科专业进行调查，并在选择音乐方面使用灵活的控制模型，自然是后续研究的一个问题。

{"title":"A boost to concentration or a distracting noise? A systematic review of surgeon and anaesthetist perspectives of the benefit of intra-operative music","authors":"K. Onuoha , D. Jones , W. Eardley","doi":"10.1016/j.surge.2024.11.002","DOIUrl":"10.1016/j.surge.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>The surgical team should be as harmonious and focussed as possible in the operating theatre. Whilst there is evidence of benefit for the use of music in the perioperative period for patient, little exists to inform of impact on those doing the surgery or anaesthesia. This review focuses on the perspectives of surgeons and anaesthetists, their views and opinions on the effect and impact of music during surgery.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using narrative synthesis. The PRISMA guidelines were followed with the use of PICO and PRISMA guided search strategy. PubMed, CINAHL and Medline were searched but filtered to only published English language papers.</div></div><div><h3>Results</h3><div>Of 329 papers identified 42 duplicates were removed. 287 were screened; of which 276 were excluded and 11 sought for retrieval. Of these, 8 were excluded for wrong population or study design, leaving 3 for analysis.</div><div>Narrative synthesis revealed three themes to guide discussion: (1) Views of surgeons and anaesthetists and the effect on music; (2) effect of music on other staff members; and (3) differences in music choices and balance of power.</div></div><div><h3>Conclusion</h3><div>Music has an overall beneficial effect on surgeons and anaesthetists, especially with regards improved concentration. As an intervention, it has global generalisability and requires little resource. Investigation across different surgical specialities and use of flexible control models in terms of choosing music is a natural subsequent research question.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages 61-66"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Scottish Open Fractures of Tibia (SOFT) audit; a multi-centre retrospective review of ortho-plastic management of tibial shaft fractures at major trauma centres (MTCs) in Scotland

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-01-27 DOI: 10.1016/j.surge.2025.01.006

J.E. Dixon , I.A. Rankin , S. Rangarajan , J. Brennan , A. Varma , D.W. Shields , I.M. Stevenson

Aims

Open fractures of the tibia are associated with significant complications, for which attempts have been made to standardise and optimise their management.

In the UK, this standard is the British Orthopaedic Association Standards for Trauma (BOAST) guidelines. The Scottish Open Fracture of Tibia (SOFT) Audit is a national review of open tibial shaft fractures across all four Scottish Trauma Networks, which aims to provide a definite review of ortho-plastic care for open tibial shaft fractures in Scotland.

Methods

A retrospective audit of all adult patients who sustained open tibial shaft fractures in Scotland from June 2021 to June 2023 was performed. The primary outcome measure was compliance with BOAST guidelines. Secondary outcome measures included infection, return to theatre, soft-tissue failure, and amputation.

Results

196 open tibial shaft fractures were identified. Common complications included infection (24 %), return to theatre (17 %), soft-tissue failure (9.7 %) and amputation (7.1 %). Complete compliance with BOAST guidelines was documented in 8.8 % of cases. Significant variation was seen between geographical regions of Scotland. No significance was seen between compliance to BOAST guidelines and any of the secondary outcome measures. Multivariate analysis identified Grade 3 Gustilo-Anderson injuries as significantly associated with post-operative infection, post-operative infection significantly associated with return to theatre, and return to theatre significantly associated with soft-tissue failure and/or amputation.

Conclusion

This study demonstrates in Scotland there is scope for improvement in cohesion with national guidance including timing of antibiotic delivery, combined ortho-plastics approach, and soft-tissue cover within 72 h of definitive fixation.

{"title":"Scottish Open Fractures of Tibia (SOFT) audit; a multi-centre retrospective review of ortho-plastic management of tibial shaft fractures at major trauma centres (MTCs) in Scotland","authors":"J.E. Dixon , I.A. Rankin , S. Rangarajan , J. Brennan , A. Varma , D.W. Shields , I.M. Stevenson","doi":"10.1016/j.surge.2025.01.006","DOIUrl":"10.1016/j.surge.2025.01.006","url":null,"abstract":"<div><h3>Aims</h3><div>Open fractures of the tibia are associated with significant complications, for which attempts have been made to standardise and optimise their management.</div><div>In the UK, this standard is the British Orthopaedic Association Standards for Trauma (BOAST) guidelines. The Scottish Open Fracture of Tibia (SOFT) Audit is a national review of open tibial shaft fractures across all four Scottish Trauma Networks, which aims to provide a definite review of ortho-plastic care for open tibial shaft fractures in Scotland.</div></div><div><h3>Methods</h3><div>A retrospective audit of all adult patients who sustained open tibial shaft fractures in Scotland from June 2021 to June 2023 was performed. The primary outcome measure was compliance with BOAST guidelines. Secondary outcome measures included infection, return to theatre, soft-tissue failure, and amputation.</div></div><div><h3>Results</h3><div>196 open tibial shaft fractures were identified. Common complications included infection (24 %), return to theatre (17 %), soft-tissue failure (9.7 %) and amputation (7.1 %). Complete compliance with BOAST guidelines was documented in 8.8 % of cases. Significant variation was seen between geographical regions of Scotland. No significance was seen between compliance to BOAST guidelines and any of the secondary outcome measures. Multivariate analysis identified Grade 3 Gustilo-Anderson injuries as significantly associated with post-operative infection, post-operative infection significantly associated with return to theatre, and return to theatre significantly associated with soft-tissue failure and/or amputation.</div></div><div><h3>Conclusion</h3><div>This study demonstrates in Scotland there is scope for improvement in cohesion with national guidance including timing of antibiotic delivery, combined ortho-plastics approach, and soft-tissue cover within 72 h of definitive fixation.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 2","pages":"Pages 87-93"},"PeriodicalIF":2.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Where do we go from here? The personal impact of adverse events and complications in surgeons: Results from a cross-sectional study 我们从这里往哪里走？外科医生不良事件和并发症的个人影响：一项横断面研究的结果。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-01-13 DOI: 10.1016/j.surge.2025.01.001

S. O'Meara , E. Doherty , K. Walsh

Objective

Medical error is an inevitable part of modern healthcare, with a potential harmful impact for the patient and the surgeon. The phenomenon of negative personal responses for healthcare workers in the aftermath of adverse events is described as the “second casualty” and can involve significant physical and psychological distress. We present results from a cross-sectional survey of surgeons and their experience in the aftermath of adverse events or complications.

Subjects and methods

Following ethical approval an anonymous online survey was distributed to all training and consultant surgeons in the Republic of Ireland. Data collected included basic demographics, personal response to an adverse event, coping strategies, contributing factors and perception of potential support structures.

Results

A total of 110 responses were received representing surgeons with a broad range of experience and specialty. Eighty-nine percent (n = 98) of surgeons described negative psychological symptoms in the aftermath of adverse events. The predominant responses were anxiety, guilt and low mood. Sixty-seven percent (n = 74) reported that their training did not prepare them for the personal impact of events but found informal peer and family support to be beneficial and were open to the implementation of formal support structures.

Conclusion

Surgeons suffer in the aftermath of negative outcomes and feel unprepared to manage the personal consequences. Institutions and representative bodies must step forward to change culture and develop supports for surgeons in the aftermath of adverse events and complications.

目的：医疗差错是现代医疗保健不可避免的一部分，对患者和外科医生都有潜在的有害影响。卫生保健工作者在不良事件发生后的消极个人反应现象被描述为“第二伤亡”，可能涉及重大的身体和心理困扰。我们目前的结果来自外科医生的横断面调查和他们的经验，在不良事件或并发症的后果。对象和方法：在伦理批准后，向爱尔兰共和国的所有培训外科医生和顾问外科医生分发了一份匿名在线调查。收集的数据包括基本人口统计数据、个人对不良事件的反应、应对策略、影响因素和对潜在支持结构的看法。结果：共收到110份答复，代表了具有广泛经验和专业的外科医生。89% （n = 98）的外科医生在不良事件发生后描述了消极的心理症状。主要的反应是焦虑、内疚和情绪低落。67% （n = 74）的人报告说，他们的培训没有让他们为事件的个人影响做好准备，但发现非正式的同伴和家庭支持是有益的，并对实施正式的支持结构持开放态度。结论：外科医生遭受负面结果的后果，感觉没有准备好处理个人后果。机构和代表机构必须挺身而出，改变文化，并在不良事件和并发症发生后为外科医生提供支持。

{"title":"Where do we go from here? The personal impact of adverse events and complications in surgeons: Results from a cross-sectional study","authors":"S. O'Meara , E. Doherty , K. Walsh","doi":"10.1016/j.surge.2025.01.001","DOIUrl":"10.1016/j.surge.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>Medical error is an inevitable part of modern healthcare, with a potential harmful impact for the patient and the surgeon. The phenomenon of negative personal responses for healthcare workers in the aftermath of adverse events is described as the “second casualty” and can involve significant physical and psychological distress. We present results from a cross-sectional survey of surgeons and their experience in the aftermath of adverse events or complications.</div></div><div><h3>Subjects and methods</h3><div>Following ethical approval an anonymous online survey was distributed to all training and consultant surgeons in the Republic of Ireland. Data collected included basic demographics, personal response to an adverse event, coping strategies, contributing factors and perception of potential support structures.</div></div><div><h3>Results</h3><div>A total of 110 responses were received representing surgeons with a broad range of experience and specialty. Eighty-nine percent (n = 98) of surgeons described negative psychological symptoms in the aftermath of adverse events. The predominant responses were anxiety, guilt and low mood. Sixty-seven percent (n = 74) reported that their training did not prepare them for the personal impact of events but found informal peer and family support to be beneficial and were open to the implementation of formal support structures.</div></div><div><h3>Conclusion</h3><div>Surgeons suffer in the aftermath of negative outcomes and feel unprepared to manage the personal consequences. Institutions and representative bodies must step forward to change culture and develop supports for surgeons in the aftermath of adverse events and complications.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 2","pages":"Pages 73-77"},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New technologies for future of surgery in Ireland: An RCSI working Group report 2024 爱尔兰未来手术的新技术：RCSI工作组报告2024。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-01-09 DOI: 10.1016/j.surge.2024.11.012

Future of New Technologies In Ireland Working Group, Writing Group, Alice Moynihan, Debbie Killeen, Ronan Cahill, Ashokkumar Singaravelu, Steering Group, David Healy, Carmel Malone, Enda Mulvany, Fergal O'Brien, Paul Ridgway, Kieran Ryan, Contributors, Mary Barry, Donal Brennan, John Caird, Camilla Carroll, Calvin Coffey, Kevin Conlon, Mark Wilson

Introduction

Surgery is a cognitive discipline whose practitioners characteristically use technology during operations for patients. With accelerating technological innovation throughout society and healthcare, we sought to develop a shared position for Irish surgery via a commissioned work programme by the Royal College of Surgeons in Ireland.

Methods

Using Stanford design principles, representative clinical specialty and academic leads and higher trainee representatives across 15 specialties were surveyed regarding sentiments, perspectives and concerns regarding now and near future technology in clinical practice, career considerations and training/education. Selected participants proceeded to semi-structured interview as deeper dive including use-case exemplar development with narrative thematic analysis.

Results

New technologies matter to surgeons and surgical practice for patients as evidenced by the high level of engagement and rich perspectives provided. However there is concern, particularly among academic groups, that Irish Surgery could be better positioned for the opportunities inherent in new technologies and better prepared strategically regarding stakeholder (surgical units, healthcare institutions, universities and especially management, health service executive and government) alignment. Investment levels are felt to be insufficient to maximally leverage new technology effectively including training investment where new ways of learning are needed as technologies such as artificial intelligence and data and analytics become more important to surgical practice beyond the current prioritisation of robotics and biomaterials.

Conclusion

While there is high engagement, clear ambition and confidence with role of new technologies in the now and near future of Irish Surgery, there is opportunity to demonstrate leadership and synergise stake holders for better healthcare.

导读：外科是一门认知学科，其从业人员在为患者进行手术时典型地使用技术。随着整个社会和医疗保健技术创新的加速，我们试图通过爱尔兰皇家外科医学院的委托工作计划，为爱尔兰外科发展一个共同的位置。方法：采用斯坦福大学的设计原则，对15个专业的代表性临床专业和学术领导以及高级实习生代表进行调查，调查内容包括对临床实践中现在和近期技术、职业考虑和培训/教育的看法、观点和关注。被选中的参与者继续进行半结构化访谈，包括用例范例开发和叙事主题分析。结果：新技术对外科医生和患者的手术实践很重要，高水平的参与和丰富的观点证明了这一点。然而，有一种担忧，特别是在学术团体中，爱尔兰外科可以更好地定位于新技术所固有的机会，并为利益相关者（外科单位、医疗机构、大学，特别是管理层、卫生服务行政人员和政府）的协调做好更好的战略准备。投资水平被认为不足以最大限度地有效利用新技术，包括培训投资，因为人工智能、数据和分析等技术对外科实践变得越来越重要，而不是目前优先考虑的机器人和生物材料。结论：虽然在爱尔兰外科的现在和不久的将来，新技术的作用有很高的参与度，明确的雄心和信心，但有机会展示领导力和协同利益相关者，以实现更好的医疗保健。

{"title":"New technologies for future of surgery in Ireland: An RCSI working Group report 2024","authors":"Future of New Technologies In Ireland Working Group, Writing Group, Alice Moynihan, Debbie Killeen, Ronan Cahill, Ashokkumar Singaravelu, Steering Group, David Healy, Carmel Malone, Enda Mulvany, Fergal O'Brien, Paul Ridgway, Kieran Ryan, Contributors, Mary Barry, Donal Brennan, John Caird, Camilla Carroll, Calvin Coffey, Kevin Conlon, Mark Wilson","doi":"10.1016/j.surge.2024.11.012","DOIUrl":"10.1016/j.surge.2024.11.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgery is a cognitive discipline whose practitioners characteristically use technology during operations for patients. With accelerating technological innovation throughout society and healthcare, we sought to develop a shared position for Irish surgery via a commissioned work programme by the Royal College of Surgeons in Ireland.</div></div><div><h3>Methods</h3><div>Using Stanford design principles, representative clinical specialty and academic leads and higher trainee representatives across 15 specialties were surveyed regarding sentiments, perspectives and concerns regarding now and near future technology in clinical practice, career considerations and training/education. Selected participants proceeded to semi-structured interview as deeper dive including use-case exemplar development with narrative thematic analysis.</div></div><div><h3>Results</h3><div>New technologies matter to surgeons and surgical practice for patients as evidenced by the high level of engagement and rich perspectives provided. However there is concern, particularly among academic groups, that Irish Surgery could be better positioned for the opportunities inherent in new technologies and better prepared strategically regarding stakeholder (surgical units, healthcare institutions, universities and especially management, health service executive and government) alignment. Investment levels are felt to be insufficient to maximally leverage new technology effectively including training investment where new ways of learning are needed as technologies such as artificial intelligence and data and analytics become more important to surgical practice beyond the current prioritisation of robotics and biomaterials.</div></div><div><h3>Conclusion</h3><div>While there is high engagement, clear ambition and confidence with role of new technologies in the now and near future of Irish Surgery, there is opportunity to demonstrate leadership and synergise stake holders for better healthcare.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 2","pages":"Pages 120-132"},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀