Jichi Medical University Institutional Repository
Not a member yet
1006 research outputs found
Sort by
Short-term outcomes of laparoscopic surgery in patients aged 75 years or older with colorectal cancer
Get PDF75歳以上の高齢者における腹腔鏡下大腸手術の治療成績を検討したので報告する。当院において2010年１月から2017年６月までの期間に大腸癌に対し腹腔鏡下大腸手術を施行した565例を対象とし，75歳未満の若年者群（474例）と75歳以上の高齢者群（91例）の２群間の短期成績を比較検討した。高齢者群において術前併存症が多くASA scoreは高値であった。また，高齢者群においてD3郭清の施行率が低く（高齢者群 41.8% vs 若年者群 54.0%，p=0.04），開腹移行率が高値であった（高齢者群 4.4％ vs 若年者群 1.1％， p=0.04）。しかし両群間において手術時間，術中出血量，術後在院日数，術後合併症発生率について有意差を認めなかった。以上より75歳以上高齢者においても75歳未満の若年者と同様に腹腔鏡下大腸手術を選択することが可能である。departmental bulletin pape
Simulation of intraosseous access is effective for resident training
Get PDFIntraosseous (IO) access can be used for the resuscitation of patients with severe traumatic injuries. However, opportunities to learn how to insert IO devices are limited for residents. The aim of this study was to perform simulated IO device placement by residents and evaluate the effectiveness of training. Residents placed IO needles into a porcine sternum under general anesthesia with guidance from an instructor. Comprehension tests and questionnaires about satisfaction and self-efficacy were conducted before and after the study. The objective evaluation was based on IO access success rate and comprehension test scores, and a subjective evaluation was obtained from questionnaire scores. Participants included 36 residents. One resident had successful clinical experience with IO access. The success rate for establishing IO access in the simulation was 100%. The rate of test completion was 100%, and that the questionnaire response rate was 61%. Mean (±standard deviation) comprehension test results improved from 9.2±0.94 to 9.6±0.79 (maximum 10; P=0.017). The questionnaire score for subjective understanding increased from 7.4±2.9 to 14±1.3 (maximum 15; P<0.0001). The score for questions specifically concerning self-efficacy increased from 1.8±0.91 to 4.1±0.64 (out of 5; P<0.0001). This simulation training improved the knowledge, subjective understanding, and self-efficacy of residents performing IO access. The success rate for confirmed IO access in this study was 100%. Simulation training may positively affect clinical performance in trauma care and requires further study.departmental bulletin pape
