The impact of feedback of intraoperative technical performance in surgery: a systematic review.
The impact of feedback of intraoperative technical performance in surgery: a systematic review.
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术中技术绩效反馈在手术中的影响：系统评价。
DOI：
10.1136/bmjopen-2014-006759
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发表时间：
2015-06-15
期刊：
影响因子：
2.9
通讯作者：
Maruthappu M
中科院分区：
文献类型：
--
作者：
Trehan A;Barnett-Vanes A;Carty MJ;McCulloch P;Maruthappu M
不断增加的患者需求、成本和对安全的重视，加上外科实习生在手术室花费的时间减少，因此有必要采取措施提高外科培训的效率。在这方面，基于术中手术表现的反馈可能是有益的。我们的目的是系统地回顾基于手术表现的术中反馈的影响。检索Medline、Embase、CogcINFO、Amed和Cochrane系统评价数据库。两名审查员使用预先确定的纳入和排除标准独立审查了引文。每项研究提取32个数据点。搜索策略产生了1531条引文。有三项研究符合条件，其中包括62名外科医生总共进行的280次手术。总体而言，基于术中手术表现的反馈被发现是提高手术效果的有效方法。在胆囊切除术中，反馈导致了手术时间的减少(p=0.022)和运动经济性的改善(p<；0.001)。在模拟的腹腔镜结肠切除术中，反馈导致器械路径长度(p=0.001)和器械平整度(p=0.045)的改善。反馈也降低了在胆囊切除术(p=0.003)、模拟腹腔镜结肠切除术(p<；0.001)和模拟肾动脉血管成形术(p=0.004)中的错误分数。此外，反馈改善了球囊放置的准确性(p=0.041)，并导致模拟肾动脉血管成形术中学习曲线更平滑，表现更早进入平台期。术中反馈似乎与手术效果的改善有关，然而，这方面的研究还很少。还需要进一步开展工作，以确定反馈的长期效益以及提供反馈的最佳手段和环境。
Increasing patient demands, costs and emphasis on safety, coupled with reductions in the length of time surgical trainees spend in the operating theatre, necessitate means to improve the efficiency of surgical training. In this respect, feedback based on intraoperative surgical performance may be beneficial. Our aim was to systematically review the impact of intraoperative feedback based on surgical performance. MEDLINE, Embase, PsycINFO, AMED and the Cochrane Database of Systematic Reviews were searched. Two reviewers independently reviewed citations using predetermined inclusion and exclusion criteria. 32 data-points per study were extracted. The search strategy yielded 1531 citations. Three studies were eligible, which comprised a total of 280 procedures by 62 surgeons. Overall, feedback based on intraoperative surgical performance was found to be a powerful method for improving performance. In cholecystectomy, feedback led to a reduction in procedure time (p=0.022) and an improvement in economy of movement (p<0.001). In simulated laparoscopic colectomy, feedback led to improvements in instrument path length (p=0.001) and instrument smoothness (p=0.045). Feedback also reduced error scores in cholecystectomy (p=0.003), simulated laparoscopic colectomy (p<0.001) and simulated renal artery angioplasty (p=0.004). In addition, feedback improved balloon placement accuracy (p=0.041), and resulted in a smoother learning curve and earlier plateau in performance in simulated renal artery angioplasty. Intraoperative feedback appears to be associated with an improvement in performance, however, there is a paucity of research in this area. Further work is needed in order to establish the long-term benefits of feedback and the optimum means and circumstances of feedback delivery.
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影响因子：
3
作者：
Jensen, Aaron R.;Wright, Andrew S.;Calhoun, Kristine E.
通讯作者：
Calhoun, Kristine E.
DOI：
10.1007/s00464-007-9356-z
发表时间：
2007-12-01
影响因子：
3.1
作者：
Grantcharov, Teodor P.;Schulze, Svend;Kristiansen, Viggo B.
通讯作者：
Kristiansen, Viggo B.
影响因子：
2.1
作者：
Harewood, G. C.;Murray, F.;Patchett, S.
通讯作者：
Patchett, S.
影响因子：
9
作者：
Strandbygaard, Jeanett;Bjerrum, Flemming;Sorensen, Jette Led
通讯作者：
Sorensen, Jette Led
影响因子：
4.3
作者：
Boyle, Emily;O'Keeffe, Dara A.;Moneley, Daragh
通讯作者：
Moneley, Daragh