ABSTRACT
Purpose@#Minimally invasive surgery (MIS) offers patients several benefits, such as smaller incisions, and fast recovery times. General surgery residents should be trained in both open and MIS. We aimed to examine the trends of minimally invasive and open procedures performed by general surgery residents in Thailand. @*Methods@#A retrospective review of the Royal College of Surgeons of Thailand and Accreditation Council for Graduate Medical Education general surgery case logs from 2007 to 2018 was performed for common open and laparoscopic general surgery operations. The data were grouped by three time periods, which were 2007–2010, 2011–2014, and 2015–2018, and analyzed to explore changes in the operative trends. @*Results@#For Thai residents, the mean number of laparoscopic operations per person per year increased from 5.97 to 9.36 (56.78% increase) and open increased from 20.02 to 27.16 (35.67% increase). There was a significant increase in the average number of minimally invasive procedures performed among cholecystectomy (5.83, 6.57, 8.10; p < 0.001) and inguinal hernia repair (0.33, 0.35, 0.66; p < 0.001). Compared to general surgery residents in the United States, Thai residents had more experience with open appendectomy, but significantly less experience with all other operations/procedures. @*Conclusion@#The number of open and minimally invasive procedures performed or assisted by Thai general surgery residents has slowly increased, but generally lags behind residents inthe United States. The Thai education program must be updated to improve residents’technical skills in open and laparoscopic surgery to remain competitive with their global partners.
ABSTRACT
Background and Objective: Primary hyperparathyroidism is now being diagnosed with increasing frequency. Simultaneously there has been an apparent change in the presentation of the disease and indication for surgery. The aim of this study was to examine the clinical presentation and pathology of parathyroid glands for primary hyperparathyroidism.Methods : This retrospective descriptive study was carried out over 14 years, from 1994 to 2008, at Srinagarind Hospital, Faculty of Medicine, KhonKaen University. Information on the clinical presentation, parathyroid hormone level, serum calcium level and pathological report of parathyroid glands was obtained from retrospective parathyroid surgical database.Results: Out of 40 patients diagnosed with primary hyperparathyroidism at Srinagarind Hospital, there were 27 female, mean age 47.22(13 – 73) years and 13 male patients. Bone fracture was the most common clinical presentation found in 19 patients, the second was renal calculi found in 11 patients, one patient was presented with bone fracture and renal calculi and 8 patients were presenteded with non-specific symptoms. Pathological reports were adenoma in 39 glands of 39 patients and hyperplasia 4 glands in one patient. Mean serum parathyroid hormone level 481.69 pg/ml (79 - 1361.7 pg/ml)and mean serum calcium level was 12.66 md/dl (9.5-16.5 mg/dl)calcium was 12.66 mg/dl (9.5 – 16.5 mg/dl) and levelConclusion: This study shows that severe bone disease with fractures are the most common presentation of primary hyperparathyroidism. The second is renal calculi. The most common pathological report was adenoma.Keywords: Primary hyperparathyroidism; clinical spectrum, pathology