Learning trauma surgery through cytoreductive surgery |
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| Institution: | 1. Department of digestive surgery, CHU Félix Guyon, allée des Topazes, Saint Denis 97400, France;2. 5th Armed Forces Medical Center, 42 rue Lauth, Strasbourg 67000, France;3. Department of digestive surgery, Begin Military Teaching Hospital, 69 avenue de Paris, Saint Mandé 94160, France;4. Intensive Care Unit, Percy Military Teaching Hospital, 101 avenue Henri Barbusse, Clamart 92140, France;5. Val de Grace Academy, 1 Place Alphonse Laveran, Paris 75005, France;1. Department of Orthopaedic Surgery and Traumatology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt;2. Department of Orthopaedic Surgery and Traumatology, Qena Faculty of Medicine, South Valley University, Kilo 6 Qena-Safaga highway, Qena, Egypt;1. The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510006, China;2. The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510006,China;3. Panyu Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou 511401, China;1. Centre for Blast Injury Studies, Imperial College London, South Kensington Campus, London SW7 2AZ, United Kingdom;2. Centre for Defence Radiology, HMS Nelson, Portsmouth, Hampshire, United Kingdom;1. Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Republic of Korea;2. Department of Orthopedic Surgery, Ajou University School of Medicine, Republic of Korea |
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| Abstract: | ObjectivesRegarding war surgery (WS), the initial and continuing education of French military gastrointestinal surgeons (FMGIS) is considered flawed and inappropriate. This results from the low incidence of gastrointestinal (GI) trauma, its predominantly non-surgical management, and a daily surgical practice that strongly differs from WS. Conversely, cytoreductive surgery (CRS) of peritoneal metastases has similarities with WS which led us to assess its potential contribution to the initial and continuing education of FMGIS in WS.MethodsWe reported the activities of the GI surgery departments of the military teaching hospitals of Percy and Begin. The first one dedicated to traumatology and the second to CRS. We then specifically looked into the surgical procedures conducted by the FMGIS during deployment from January 2004 to December 2014.ResultsAmongst the 600 severe trauma patients admitted to the Percy trauma center between January 2019 and December 2020, 17 underwent abdominal surgery with a total of 25 procedures performed. During the same period, 61 patients undertook CRS in Begin with an average of 7 surgical processes per patient carried out and a total of 418 abdominal surgical procedures. Outside abdominal packing and nephrectomy (not performed in CRS), the numbers of splenectomy, gastrointestinal / gynecological resections (hysterectomy and/or adnexectomy), or liver resection were higher during CRS compared to abdominal trauma surgery with 10 times less patients (10 vs 1, 43 vs 9, 20 vs 0, 6 vs 0, respectively).ConclusionCRS, through its similarities with WS, seemed to be an appropriate tool for the initial and continuing education of FMGIS in WS and, to an extent, of civilian trauma surgeons who could eventually treat terrorist attacks casualties on the national territory. |
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