背景:照顾居住在农村和地区的33%的澳大利亚人的外科医生短缺。为了帮助了解农村普外科需要什么,并优化对有抱负的农村外科医生的培训,这项研究的目的是分析南澳大利亚州四家农村医院的普外科手术病例数和病例数。
方法:这是一项回顾性的多中心研究,涉及南澳大利亚州的四个农村外科中心(MtGambier,Whyalla,奥古斯塔港,和林肯港)。从部门审核中提取了2014-2020年进行的外科手术。为了确定外科手术随时间的趋势,数据分为三个时间段(时间段1:2014年2月-2015年12月,时间段2:2016年1月-2017年12月,时间段3:2018年1月-2020年3月)。
结果:共进行了44191次外科手术,70.2%为日间程序。54%是内镜手术,46%为手术程序。60.6%的手术方式为普外科手术。28.5%是基于普通外科的亚专科(结直肠,肝胰胆,上消化道,和乳房)。10.9%为非普外科亚专科(泌尿外科,塑料,血管,骨科,头部和颈部,和妇产科)。在这三个时间段内,所有方面(内窥镜和手术程序)的手术病例数没有统计学上的显着波动。
结论:澳大利亚农村普通外科医生的手术大部分是内窥镜检查。手术程序主要以普外科为主。配备有抱负的农村普通外科医生来管理基本的非普通外科手术程序(泌尿外科,血管,和骨科)。
There is a shortage of surgeons caring for the 33% of Australians residing in rural and regional areas. In order to help appreciate what rural general surgery entails and optimize training for aspiring rural surgeons, the aim of this study was to analyse the general surgical departments\' procedural caseload and casemix in four rural South Australian hospitals.
This is a retrospective multi-centre study involving four rural surgical centres in South Australia (Mt Gambier, Whyalla, Port Augusta, and Port Lincoln). Surgical procedures performed from 2014-2020 were extracted from departmental audits. To identify trends of surgical procedure over time, the data was divided into three time periods (Period 1: February 2014-December 2015, Period 2: January 2016-December 2017, Period 3: January 2018-March 2020).
A total of 44 191 surgical procedures were performed, 70.2% being day procedures. 54% were endoscopic procedures, 46% were operative procedures. 60.6% of the operative procedures were general surgery procedures. 28.5% were general surgery-based subspecialty (colorectal, hepato-pancreato-biliary, upper gastrointestinal, and breast). 10.9% were non-general surgery-based subspecialty (urology, plastics, vascular, orthopaedics, head and neck, and obstetrics and gynaecology). There were no statistically significant fluctuations in procedure caseload in all aspects (endoscopic and operative procedures) over the three time periods.
The majority of a rural Australian general surgeon\'s procedures are endoscopic. Operative procedures are mainly general surgery based. It may be beneficial to equip aspiring rural general surgeons to manage basic non-general surgery procedures (urological, vascular, and orthopaedic).