Pub Date : 2025-01-01DOI: 10.1016/j.sopen.2025.01.001
Dietrich Doll , Susanne Haas , Ida Kaad Faurschou , Theo Hackmann , Henrike Heitmann , Myriam Braun-Münker , Christina Oetzmann von Sochaczewski
Background
Pilonidal sinus disease uncommon in pre-pubertal children. The preferred treatment for pediatric pilonidal sinus patients remains unclear. A growing body of evidence indicates that pediatric pilonidal sinus disease recurs earlier than in adults. We therefore aimed to investigate recurrence rates and the recurrence rates of different surgical approaches.
Methods
Some 1217 studies on pilonidal sinus disease, encompassing 134,663 patients were eligible. From them, 5807 pediatric patients were identified. Recurrence rates were compared between adults and children.
Results
Pediatric pilonidal sinus patients have a higher 5-year recurrence rate compared to adults (46 % vs. 11.5 %; p < 0.0001). The subgroup of individuals aged 16–18 years appears to experience recurrences 12 months earlier than those below the age of 16. 46.4 % of all pediatric recurrences occur within 5 years.
Conclusions
Pediatric pilonidal sinus disease seems to follow a different course in terms of recurrence rate compared to adults with a substantially increased probability of developing recurrent pilonidal sinus disease within the first five years after surgery. Due to the limited evidence base, especially in terms of the surgical approach, additional data is required to gain a more detailed insight into the matter and to improve surgical care for children and adolescents.
{"title":"Pediatric pilonidal sinus disease: Recurrence rates of different age groups compared to adults","authors":"Dietrich Doll , Susanne Haas , Ida Kaad Faurschou , Theo Hackmann , Henrike Heitmann , Myriam Braun-Münker , Christina Oetzmann von Sochaczewski","doi":"10.1016/j.sopen.2025.01.001","DOIUrl":"10.1016/j.sopen.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Pilonidal sinus disease uncommon in pre-pubertal children. The preferred treatment for pediatric pilonidal sinus patients remains unclear. A growing body of evidence indicates that pediatric pilonidal sinus disease recurs earlier than in adults. We therefore aimed to investigate recurrence rates and the recurrence rates of different surgical approaches.</div></div><div><h3>Methods</h3><div>Some 1217 studies on pilonidal sinus disease, encompassing 134,663 patients were eligible. From them, 5807 pediatric patients were identified. Recurrence rates were compared between adults and children.</div></div><div><h3>Results</h3><div>Pediatric pilonidal sinus patients have a higher 5-year recurrence rate compared to adults (46 % vs. 11.5 %; <em>p</em> < 0.0001). The subgroup of individuals aged 16–18 years appears to experience recurrences 12 months earlier than those below the age of 16. 46.4 % of all pediatric recurrences occur within 5 years.</div></div><div><h3>Conclusions</h3><div>Pediatric pilonidal sinus disease seems to follow a different course in terms of recurrence rate compared to adults with a substantially increased probability of developing recurrent pilonidal sinus disease within the first five years after surgery. Due to the limited evidence base, especially in terms of the surgical approach, additional data is required to gain a more detailed insight into the matter and to improve surgical care for children and adolescents.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 50-56"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anastomotic leakage is a severe complication of esophagectomy, therefore early detection is crucial. Presepsin is a biomarker for early diagnosis of infectious complications. This study assessed presepsin as a biomarker for anastomotic leakage after esophagectomy, compared to C-reactive protein (CRP), white blood cells (WBCs), and neutrophils (Neuts).
Materials and methods
This study enrolled 27 patients between October 2019 and December 2020. Levels of presepsin, CRP, WBCs, and Neuts were measured preoperatively and on postoperative days (PODs) 1, 3, 5, and 7.
Results
Five patients had anastomotic leakage. Their presepsin levels on POD 7 were significantly higher and tended to be higher on POD 5 (p = 0.04 and p = 0.06, respectively) compared to those without leakage. The area under the curve values for presepsin were highest on PODs 5 and 7 (0.89 and 0.83). Optimal cut-off values for presepsin were 400 pg/mL (sensitivity 100 %; specificity 81.9 %) on POD 5 and similar on POD 7.
Conclusions
Presepsin levels on PODs 5 and 7 effectively detect anastomotic leakage after esophagectomy, making it a valuable, simple, non-invasive early detection test.
{"title":"The usefulness of presepsin in the early detection of anastomotic leakage after esophagectomy","authors":"Yoshiro Imai, Ryo Tanaka, Kentaro Matsuo, Hidero Yoshimoto, Mitsuhiro Asakuma, Hideki Tomiyama, Sang-Woong Lee","doi":"10.1016/j.sopen.2025.01.003","DOIUrl":"10.1016/j.sopen.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Anastomotic leakage is a severe complication of esophagectomy, therefore early detection is crucial. Presepsin is a biomarker for early diagnosis of infectious complications. This study assessed presepsin as a biomarker for anastomotic leakage after esophagectomy, compared to C-reactive protein (CRP), white blood cells (WBCs), and neutrophils (Neuts).</div></div><div><h3>Materials and methods</h3><div>This study enrolled 27 patients between October 2019 and December 2020. Levels of presepsin, CRP, WBCs, and Neuts were measured preoperatively and on postoperative days (PODs) 1, 3, 5, and 7.</div></div><div><h3>Results</h3><div>Five patients had anastomotic leakage. Their presepsin levels on POD 7 were significantly higher and tended to be higher on POD 5 (<em>p</em> = 0.04 and <em>p</em> = 0.06, respectively) compared to those without leakage. The area under the curve values for presepsin were highest on PODs 5 and 7 (0.89 and 0.83). Optimal cut-off values for presepsin were 400 pg/mL (sensitivity 100 %; specificity 81.9 %) on POD 5 and similar on POD 7.</div></div><div><h3>Conclusions</h3><div>Presepsin levels on PODs 5 and 7 effectively detect anastomotic leakage after esophagectomy, making it a valuable, simple, non-invasive early detection test.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 75-80"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.sopen.2024.12.002
Tyler Liang MD , Areg Grigorian MD , Robert Painter MD , James Jeng MD , Theresa Chin MD , Laura F. Goodman MD MPH , Yigit S. Guner MD , Catherine Kuza MD , Jeffry Nahmias MD MHPE
Background
Unplanned intensive care unit (ICU) admission (UIA) is associated with increased morbidity in adult trauma patients, however, is not well studied in pediatric trauma patients (PTPs). We sought to identify predictors of UIA, hypothesizing PTPs with UIA have increased odds of mortality.
Methods
The 2017–2019 Trauma Quality Improvement Program (TQIP) database was queried for PTPs ≤16-years-old admitted to non-ICU level of care. Patients with UIA were compared to those without UIA. Multivariable logistic regression analysis was performed to determine predictors of UIA.
Results
From 142,160 PTPs, 233 patients had UIA (<1 %). The UIA group had increased acute kidney injury (2.6 % vs 0 %, p < 0.001), length of stay (7 vs 2 days, p < 0.001), and mortality (1.3 % vs. 0.1 %, p < 0.001). Independent predictors of UIA included ureteral, esophageal, and brain injury (all p < 0.001).
Conclusion
UIA for PTPs is rare but associated with increased complications and death. Significant predictors of UIA include ureteral, esophageal and brain injury.
{"title":"Outcomes and predictors of unplanned intensive care unit admission for pediatric trauma patients","authors":"Tyler Liang MD , Areg Grigorian MD , Robert Painter MD , James Jeng MD , Theresa Chin MD , Laura F. Goodman MD MPH , Yigit S. Guner MD , Catherine Kuza MD , Jeffry Nahmias MD MHPE","doi":"10.1016/j.sopen.2024.12.002","DOIUrl":"10.1016/j.sopen.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Unplanned intensive care unit (ICU) admission (UIA) is associated with increased morbidity in adult trauma patients, however, is not well studied in pediatric trauma patients (PTPs). We sought to identify predictors of UIA, hypothesizing PTPs with UIA have increased odds of mortality.</div></div><div><h3>Methods</h3><div>The 2017–2019 Trauma Quality Improvement Program (TQIP) database was queried for PTPs ≤16-years-old admitted to non-ICU level of care. Patients with UIA were compared to those without UIA. Multivariable logistic regression analysis was performed to determine predictors of UIA.</div></div><div><h3>Results</h3><div>From 142,160 PTPs, 233 patients had UIA (<1 %). The UIA group had increased acute kidney injury (2.6 % vs 0 %, p < 0.001), length of stay (7 vs 2 days, p < 0.001), and mortality (1.3 % vs. 0.1 %, p < 0.001). Independent predictors of UIA included ureteral, esophageal, and brain injury (all p < 0.001).</div></div><div><h3>Conclusion</h3><div>UIA for PTPs is rare but associated with increased complications and death. Significant predictors of UIA include ureteral, esophageal and brain injury.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 30-34"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.sopen.2024.12.004
Qi Fan MM , Pengcheng Wei MM , Delin Ma MD , Qian Cheng MD , Jie Gao MD , Jiye Zhu MD , Zhao Li MD
Aims
To evaluate the efficacy of re-resection in recurrent hepatocellular carcinoma (rHCC), identify prognostic factors, and provide clinical guidance.
Methods
A retrospective analysis was conducted on 130 rHCC patients undergoing re-resection and 60 primary HCC patients undergoing initial hepatectomy at Peking University People's Hospital (2014–2022). Disease-free survival (DFS) and overall survival (OS) were compared. Prognostic factors were identified using univariate and multivariate COX regression analyses.
Results
Baseline characteristics were comparable between groups (P > 0.05). DFS was similar between groups (30.8 vs. 32.2 months, P = 0.612). The 1-year, 2-year, and 3-year DFS rates for the re-resection group were 88.5 %, 64.9 %, and 56.7 %, respectively, versus 88.3 %, 65.0 %, and 53.3 % for the primary resection group. OS was lower in the re-resection group (36.1 vs. 47.2 months, P = 0.041) with 1-year, 2-year, and 3-year OS rates of 90.8 %, 73.1 %, and 60.0 %, compared to 95.0 %, 80.0 %, and 68.3 % for the primary resection group. Significant factors affecting DFS were Child-Pugh classification (P = 0.044), time to recurrence (P = 0.002), tumor differentiation (P = 0.044), and satellite nodules (P = 0.019). Factors influencing OS included Child-Pugh classification (P = 0.040), time to recurrence (P = 0.002), and tumor differentiation (P = 0.032).
Conclusions
Re-resection is an effective treatment option for rHCC, with favorable outcomes as measured by DFS and OS, though OS is lower compared to initial hepatectomy. Key prognostic factors include Child-Pugh classification, time to recurrence, tumor differentiation, and satellite nodules.
{"title":"Therapeutic efficacy and prognostic indicators in re-resection for recurrent hepatocellular carcinoma: Insights from a retrospective study","authors":"Qi Fan MM , Pengcheng Wei MM , Delin Ma MD , Qian Cheng MD , Jie Gao MD , Jiye Zhu MD , Zhao Li MD","doi":"10.1016/j.sopen.2024.12.004","DOIUrl":"10.1016/j.sopen.2024.12.004","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the efficacy of re-resection in recurrent hepatocellular carcinoma (rHCC), identify prognostic factors, and provide clinical guidance.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 130 rHCC patients undergoing re-resection and 60 primary HCC patients undergoing initial hepatectomy at Peking University People's Hospital (2014–2022). Disease-free survival (DFS) and overall survival (OS) were compared. Prognostic factors were identified using univariate and multivariate COX regression analyses.</div></div><div><h3>Results</h3><div>Baseline characteristics were comparable between groups (<em>P</em> > 0.05). DFS was similar between groups (30.8 vs. 32.2 months, <em>P</em> = 0.612). The 1-year, 2-year, and 3-year DFS rates for the re-resection group were 88.5 %, 64.9 %, and 56.7 %, respectively, versus 88.3 %, 65.0 %, and 53.3 % for the primary resection group. OS was lower in the re-resection group (36.1 vs. 47.2 months, <em>P</em> = 0.041) with 1-year, 2-year, and 3-year OS rates of 90.8 %, 73.1 %, and 60.0 %, compared to 95.0 %, 80.0 %, and 68.3 % for the primary resection group. Significant factors affecting DFS were Child-Pugh classification (<em>P</em> = 0.044), time to recurrence (<em>P</em> = 0.002), tumor differentiation (P = 0.044), and satellite nodules (<em>P</em> = 0.019). Factors influencing OS included Child-Pugh classification (<em>P</em> = 0.040), time to recurrence (<em>P</em> = 0.002), and tumor differentiation (<em>P</em> = 0.032).</div></div><div><h3>Conclusions</h3><div><em>Re</em>-resection is an effective treatment option for rHCC, with favorable outcomes as measured by DFS and OS, though OS is lower compared to initial hepatectomy. Key prognostic factors include Child-Pugh classification, time to recurrence, tumor differentiation, and satellite nodules.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 16-23"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The advantage of intraoperative neuromonitoring (IONM) has been widely accepted in thyroid/parathyroid surgery. However, there are discrepancies of amplitudes on recurrent laryngeal nerve (RLN) palsy and vocal cord paralysis (VCP) because of amplitude variations among individuals. Accordingly, the universal usefulness of quantitative amplitude value per se among patients were assessed.
Study design
IONM using a 4-step method (Vagus nerve (V1)-RLN (R1)-R2-V2) was applied to 777 RLNs (510 patients). Forty-nine RLNs were excluded because of either loss of signal without preoperative VCP or combined RLN resection. The remaining 728 RLNs were evaluated. The optimal cut-offs of amplitudes or ratios of amplitude decrease on VCP were determined and evaluated. An independent recent cohort (177 RLNs) was analyzed for validation.
Results
Quantitative amplitudes of V2 or R2, and V2/V1 or R2/R1 ratio predicted VCP. The V2 of 117–216 μV predicted VCP with high (>80 %) sensitivity and specificity. Interestingly, the AUC of ROC curve of V2 was the highest, and a cut-off 124 μV of V2 most excellently predicted VCP with the highest sensitivity, specificity, and both positive and negative predictive values. In dissociative analyses, a V2 cut-off 124 μV still excellently predicted VCP in all ranges of initial V1 ≥ 100 μV. In a validation cohort, the V2 of 126–205 μV (cut-off 197 μV) predicted VCP with both high (>80 %) sensitivity and specificity.
Conclusions
A quantitative V2 amplitude can predict postoperative VCP among individuals as a simple and a second option, that may be especially useful in some circumstances with unavoidable insufficient initial exposure of vagus nerve.
{"title":"A quantitative amplitude of vagus nerve obtained by intraoperative neuromonitoring predicts postoperative vocal cord paralysis among patients in thyroid/parathyroid surgery as a second option","authors":"Hiroshi Katoh MD, FACS , Riku Okamoto MD , Kanako Naito MD , Tomoya Mitsuma MD , Mariko Kikuchi MD , Takaaki Tokito MD , Takeshi Naitoh MD, FACS , Naoki Hiki MD , Yusuke Kumamoto MD , Takafumi Sangai MD","doi":"10.1016/j.sopen.2024.12.009","DOIUrl":"10.1016/j.sopen.2024.12.009","url":null,"abstract":"<div><h3>Background</h3><div>The advantage of intraoperative neuromonitoring (IONM) has been widely accepted in thyroid/parathyroid surgery. However, there are discrepancies of amplitudes on recurrent laryngeal nerve (RLN) palsy and vocal cord paralysis (VCP) because of amplitude variations among individuals. Accordingly, the universal usefulness of quantitative amplitude value <em>per se</em> among patients were assessed.</div></div><div><h3>Study design</h3><div>IONM using a 4-step method (Vagus nerve (V1)-RLN (<em>R</em>1)-R2-V2) was applied to 777 RLNs (510 patients). Forty-nine RLNs were excluded because of either loss of signal without preoperative VCP or combined RLN resection. The remaining 728 RLNs were evaluated. The optimal cut-offs of amplitudes or ratios of amplitude decrease on VCP were determined and evaluated. An independent recent cohort (177 RLNs) was analyzed for validation.</div></div><div><h3>Results</h3><div>Quantitative amplitudes of V2 or R2, and V2/V1 or R2/R1 ratio predicted VCP. The V2 of 117–216 μV predicted VCP with high (>80 %) sensitivity and specificity. Interestingly, the AUC of ROC curve of V2 was the highest, and a cut-off 124 μV of V2 most excellently predicted VCP with the highest sensitivity, specificity, and both positive and negative predictive values. In dissociative analyses, a V2 cut-off 124 μV still excellently predicted VCP in all ranges of initial V1 ≥ 100 μV. In a validation cohort, the V2 of 126–205 μV (cut-off 197 μV) predicted VCP with both high (>80 %) sensitivity and specificity.</div></div><div><h3>Conclusions</h3><div>A quantitative V2 amplitude can predict postoperative VCP among individuals as a simple and a second option, that may be especially useful in some circumstances with unavoidable insufficient initial exposure of vagus nerve.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 57-65"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.sopen.2024.12.007
Nicholas J. Zyromski MD , David Stewart MD
{"title":"How to review a manuscript for journal publication: A primer for surgery residents","authors":"Nicholas J. Zyromski MD , David Stewart MD","doi":"10.1016/j.sopen.2024.12.007","DOIUrl":"10.1016/j.sopen.2024.12.007","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 66-68"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/S2589-8450(24)00136-2
{"title":"Acknoledgement of Reviewers","authors":"","doi":"10.1016/S2589-8450(24)00136-2","DOIUrl":"10.1016/S2589-8450(24)00136-2","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"22 ","pages":"Page I"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-23DOI: 10.1016/j.sopen.2024.11.002
Romina Maria Roesch , Raffaella Griffo , Isabella Metelmann , Lena Brendel , Maria Ada Presotto , Katrin Welcker , Hauke Winter , Laura Valentina Klotz
Background
Thoracic surgery is an expanding surgical specialty, but a shortage of qualified and motivated thoracic surgery residents is expected. It is estimated that around 23 % of all surgical specialist jobs will be vacant by 2030. We therefore need to assess the current clinical situation and urgently improve the recruitment and training of our next generation of surgeons.
Methods
Using the online survey (Lime Survey), a questionnaire (28 questions) was created to analyze the current nationwide situation of residency in thoracic surgery. The survey was sent to all postgraduate trainees in thoracic surgery departments in Germany. The current status on residency-programs, scientific interest, the attractiveness of thoracic surgery, and the demographics of the participants were evaluated. The survey also evaluated specific ways to increase attractiveness.
The survey was conducted in collaboration with “Frauen in der Thoraxchirurgie” by the “Junges Forum der Deutschen Gesellschaft für Thoraxchirurgie”. The survey was sent to all residents and young specialists in Germany. A total of 187 participants responded.
Results
Out of 187 participants, 123 questionnaires (65.8 %) were completed. Mean age was 36.3 ± 6.9 years. 62.6 % of the participants were male. About 70 % work in an independent thoracic surgery department, while the rest is affiliated with another specialty department. 50 % have completed a doctorate in medicine.
Conclusion
The development of an objective and structured training plan could define the roles and responsibilities of the senior surgeon and the trainee, leading to improved training and, at the very least, ensuring good recruitment of junior thoracic surgeons.
背景胸外科是一个不断发展的外科专科，但预计合格且积极进取的胸外科住院医师将出现短缺。据估计，到 2030 年，大约 23% 的外科专家职位将空缺。因此，我们需要评估当前的临床状况，并紧急改进下一代外科医生的招聘和培训工作。方法利用在线调查（Lime Survey）制作了一份问卷（28 个问题），以分析当前全国胸外科住院医师的状况。调查对象为德国胸外科所有研究生学员。对住院医师培训项目的现状、科研兴趣、胸外科的吸引力以及参与者的人口统计学特征进行了评估。该调查由 "德国胸外科协会青年论坛"（Junges Forum der Deutschen Gesellschaft für Thoraxchirurgie）与 "胸外科中的女性"（Frauen in der Thoraxchirurgie）合作进行。调查问卷发送给了德国所有住院医师和年轻专家。结果 在 187 名参与者中，123 人（65.8%）完成了问卷调查。平均年龄为 36.3 ± 6.9 岁。62.6%的参与者为男性。约 70% 的参与者在独立的胸外科部门工作，其余则隶属于其他专业部门。结论制定客观、结构化的培训计划可以明确资深外科医生和受训者的角色和责任，从而改善培训，至少可以确保招聘到优秀的初级胸外科医生。
{"title":"Thoracic surgery - An underestimated dream job?","authors":"Romina Maria Roesch , Raffaella Griffo , Isabella Metelmann , Lena Brendel , Maria Ada Presotto , Katrin Welcker , Hauke Winter , Laura Valentina Klotz","doi":"10.1016/j.sopen.2024.11.002","DOIUrl":"10.1016/j.sopen.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Thoracic surgery is an expanding surgical specialty, but a shortage of qualified and motivated thoracic surgery residents is expected. It is estimated that around 23 % of all surgical specialist jobs will be vacant by 2030. We therefore need to assess the current clinical situation and urgently improve the recruitment and training of our next generation of surgeons.</div></div><div><h3>Methods</h3><div>Using the online survey (Lime Survey), a questionnaire (28 questions) was created to analyze the current nationwide situation of residency in thoracic surgery. The survey was sent to all postgraduate trainees in thoracic surgery departments in Germany. The current status on residency-programs, scientific interest, the attractiveness of thoracic surgery, and the demographics of the participants were evaluated. The survey also evaluated specific ways to increase attractiveness.</div><div>The survey was conducted in collaboration with “Frauen in der Thoraxchirurgie” by the “Junges Forum der Deutschen Gesellschaft für Thoraxchirurgie”. The survey was sent to all residents and young specialists in Germany. A total of 187 participants responded.</div></div><div><h3>Results</h3><div>Out of 187 participants, 123 questionnaires (65.8 %) were completed. Mean age was 36.3 ± 6.9 years. 62.6 % of the participants were male. About 70 % work in an independent thoracic surgery department, while the rest is affiliated with another specialty department. 50 % have completed a doctorate in medicine.</div></div><div><h3>Conclusion</h3><div>The development of an objective and structured training plan could define the roles and responsibilities of the senior surgeon and the trainee, leading to improved training and, at the very least, ensuring good recruitment of junior thoracic surgeons.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"22 ","pages":"Pages 79-84"},"PeriodicalIF":1.4,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-16DOI: 10.1016/j.sopen.2024.11.001
Olubunmi A. Fariyike , Jacqueline Yao , Mehdi Baqri , Peggy Liao , Catherine Mohr , George Korir , Taseer Feroze Din , Adam L. Kushner , Sherry M. Wren
Objective
We aimed to determine the most important perceived barriers to the implementation of self-administered training and assessment in surgical education according to subject matter experts. With these findings, design thinking was used to explore possible interventions and develop a theory of change for overcoming identified barriers. Specifically, implementation was focused on expanding the surgical skills of associate clinicians (ACs) in low-to-middle-income countries (LMICs).
Methods
A qualitative study with 10 field experts representing surgeons, educators, and engineers from the US, South America, and East and West Africa was conducted. Interviewees were selected through purposeful snowball sampling until thematic saturation. Semi-structured interviews were conducted over video conference or in-person. Open-ended responses were synthesized, coded, and used to identify key barriers for scaling simulation-based learning and self-administered training and assessment in low-resource settings.
Results
We identified four major barriers to widespread implementation of self-administered training and assessment: demonstration of the safety and quality of surgical care provided after self-administered training; validation of the principle of self-administered training and assessment; translation of simulation skills to surgical knowledge; and integration into existing task shifting and task sharing legal landscapes.
Discussion
Increasing surgical capacity in LMICs is an urgent need that could be expanded with carefully developed self-administered training and assessment for ACs. The implementation process will be variable depending on local culture and regulations but is dependent on an international community of local champions to first produce a common body of evidence supporting the technology's utility and then to generate local excitement for its integration into existing systems.
{"title":"See one, teach yourself one, do one: Barriers and opportunities in self-administered training and assessment for global surgical education","authors":"Olubunmi A. Fariyike , Jacqueline Yao , Mehdi Baqri , Peggy Liao , Catherine Mohr , George Korir , Taseer Feroze Din , Adam L. Kushner , Sherry M. Wren","doi":"10.1016/j.sopen.2024.11.001","DOIUrl":"10.1016/j.sopen.2024.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to determine the most important perceived barriers to the implementation of self-administered training and assessment in surgical education according to subject matter experts. With these findings, design thinking was used to explore possible interventions and develop a theory of change for overcoming identified barriers. Specifically, implementation was focused on expanding the surgical skills of associate clinicians (ACs) in low-to-middle-income countries (LMICs).</div></div><div><h3>Methods</h3><div>A qualitative study with 10 field experts representing surgeons, educators, and engineers from the US, South America, and East and West Africa was conducted. Interviewees were selected through purposeful snowball sampling until thematic saturation. Semi-structured interviews were conducted over video conference or in-person. Open-ended responses were synthesized, coded, and used to identify key barriers for scaling simulation-based learning and self-administered training and assessment in low-resource settings.</div></div><div><h3>Results</h3><div>We identified four major barriers to widespread implementation of self-administered training and assessment: demonstration of the safety and quality of surgical care provided after self-administered training; validation of the principle of self-administered training and assessment; translation of simulation skills to surgical knowledge; and integration into existing task shifting and task sharing legal landscapes.</div></div><div><h3>Discussion</h3><div>Increasing surgical capacity in LMICs is an urgent need that could be expanded with carefully developed self-administered training and assessment for ACs. The implementation process will be variable depending on local culture and regulations but is dependent on an international community of local champions to first produce a common body of evidence supporting the technology's utility and then to generate local excitement for its integration into existing systems.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"22 ","pages":"Pages 74-78"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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