La Escuela Finochietto. Una mirada personal retrospectiva y prospectiva / Finochietto School. A personal retrospective and prospective view

En este artículo el autor primero relata su ingreso y su formación como cirujano en la Escuela Finochietto; comparte sus sentires íntimos, las anécdotas y las experiencias vividas junto a discípulos directos de Ricardo Finochietto, en particular con su maestro, Delfín Luis Vilanova. Más adelante, el relato cuenta sobre su especialización como cirujano plástico junto al Dr. José Alberto Cerisola, también discípulo directo de Finochietto. Y por último, el autor habla sobre su proceso de «mutación¼ de cirujano a terapeuta y sobre cómo influyó la formación como cirujano en la Escuela en el desarrollo de la técnica terapéutica que emplea. (AU)

In this article, the author first relates his admission and training as a surgeon at the Finochietto School. He shares his intimate feelings, anecdotes and experiences with direct disciples of Ricardo Finochietto, particularly with his teacher, Delfín Luis Vilanova. Later on, he talks about his specialization as a plastic surgeon together with Dr. José Alberto Cerisola, also a direct disciple of Finochietto. Finally, he refers to the process of "mutation" from surgeon to therapist and how his training as a surgeon at the School influenced the development of the therapeutic technique that he uses. (AU)

El final del Hospital Rawson y la diáspora finochiettista. A 45 años de estos hechos / The end of the Rawson Hospital and the finochiettista diaspora. 45 years after these events

La Asociación Médica Argentina (AMA) reconoce el valor de la Escuela Quirúrgica de los hermanos Finochietto y por tal motivo efectúa un homenaje anual desde el año 2002. En este artículo se hace una breve reseña histórica del Hospital Rawson, donde se inició y desarrolló dicha escuela. Se resaltan dos hechos: por un lado, el término "diáspora finochiettista", porque la dispersión de los cirujanos fue obligada y tuvieron que abandonar su lugar de procedencia original, el Hospital Rawson y, por el otro, que dicho nosocomio nació y murió como consecuencia de movimientos políticos cívico-militares. (AU)

The Argentine Medical Association (AMA) recognizes the value of the Surgical School of the Finochietto brothers, and for this reason has paid an annual tribute since 2002. Tthis article provides a brief historical review of the Rawson Hospital, where the school was initiated and developed. Two facts are highlighted: on the one hand, the term "Finochiettista diaspora" because the dispersal of the surgeons was forced and they had to leave their original place of origin, the Rawson Hospital; and on the other hand, the fact that this hospital was born and died as a consequence of civil-military political movements. (AU)

Inteligencia emocional y su importancia en el proceso formativo de especialidades médico-quirúrgicas / Emotional Intelligence and its Importance on the Training Process as within Medical-Surgical Specialties

Introducción: La inteligencia emocional es una habilidad blanda, definida como la capacidad de reconocer las emociones propias y ajenas para gestionarlas frente a otros de manera adecuada. Este tipo de inteligencia se relaciona con competencias y aptitudes humanas en diferentes áreas sociales, académicas y de trabajo. Objetivo: Describir el papel de la inteligencia emocional en la práctica clínica de los residentes médicos, como marco de referencia para su aplicación en la educación teórico-práctica y la realización de futuras investigaciones. Métodos: Se realizó una revisión de la literatura en las bases de datos PubMed, LILACS y Google Scholar. Se emplearon operadores lógicos mediante distintas combinaciones: MeSH: Emotional Intelligence, Medical Residencies, Education, Medical, Education, Medical, Graduate; y DeCS: Inteligencia Emocional, Residencia Médica, Educación Médica, Educación de Postgrado en Medicina. La búsqueda se limitó por año, idioma y acceso libre, teniendo en cuenta criterios de inclusión y exclusión. Se obtuvieron 279 resultados, de los cuales fueron seleccionados 26 para ser incluidos en la revisión y síntesis de los resultados. Resultados: Los resultados se organizaron según su relación con la inteligencia emocional en: medición en residentes médico-quirúrgicos, niveles de estrés y burnout, empatía en la relación médico-paciente, desempeño académico, bienestar y satisfacción laboral. Conclusiones: La inteligencia emocional en los residentes médico-quirúrgicos se ha relacionado con menores niveles de estrés y burnout, comunicación asertiva, mayor empatía con los pacientes y calidad en la atención médica; además, con elevado rendimiento académico, mejores habilidades de enseñanza, liderazgo y motivación; y, finalmente, con mejor bienestar psicológico, satisfacción laboral y rendimiento clínico(AU)

Introduction: Emotional intelligence is a soft skill, defined as the ability to recognize one's own and others' emotions in view of managing them in front of others adequately. This type of intelligence is related to human competences and skills in different social, academic and occupational areas. Objective: To describe the role of emotional intelligence in the clinical practice of medical residents, as a frame of reference for its application in theoretical-practical education and the development of future research. Methods: A literature review was carried out in the PubMed, LILACS and Google Scholar databases. Logical operators were used by means of different combinations from the Medical Subject Headings: Emotional Intelligence, Medical Residencies, Education, Medical, Education, Medical, Graduate. The following combinations from the Health Sciences Descriptors were also used: "Inteligencia Emocional [emotional Intelligence], Residencia Médica [medical residence], Educación Médica [medical education], Educación de Postgrado en Medicina [postgraduate education in Medicine]. The search was limited by year, language and free access, taking into account inclusion and exclusion criteria. A total of 279 results were obtained, of which 26 were selected to be included in the review and synthesis. Results: The results were organized, according to their relationship with emotional intelligence, in measurement in medical-surgical residents, levels of stress and burnout, empathy in the doctor-patient relationship, academic performance, well-being, and job satisfaction. Conclusions: Emotional intelligence in medical-surgical residents has been related to lower levels of stress and burnout, assertive communication, greater empathy with patients, and quality in medical care; furthermore, with high academic performance, better skills for teaching, leadership and motivation; and, finally, with better psychological well-being, job satisfaction and clinical performance(AU)

George W. Crile (1864-1943); excepcional cirurgião americano / George W. Crile (1864-1943); excepcional cirujano estadounidense / George W. Crile (1864-1943); exceptional American surgeon

George W. Crile (1864-1943); excepcional cirurgião americano, que serviu no Corpo Médico do Exército durante a Guerra Hispano-Americana. Durante a Primeira Guerra Mundial, foi diretor cirúrgico do American Ambulance Hospital em Neuilly, na França. Ajudou fundar o American College of Surgeons em 1913, foi membro e diretor não apenas dessa organização, mas também da American Medical Association, da American Surgical Association, da Royal Academy of Surgeons e da Royal Academy of Medicine (Reino Unido). Em 1921, foi cofundador da Cleveland Clinic em Cleveland, Ohio, EUA. Foi um importante médico cujas pesquisas e escritos incluíam choque cirúrgico, função glandular, pressão arterial e transfusões, neurose de guerra e os efeitos da cirurgia em tempos de guerra. Ele também foi um cirurgião extraordinário e prolífico que introduziu inovações no tratamento cirúrgico de muitas patologias. Embora sua pesquisa tenha sido publicada há muito tempo, suas contribuições para a medicina continuam sendo fundamentais para a prática clínica nas salas de cirurgia e unidades de terapia intensiva atuais.

George W. Crile (1864-1943) fue un excepcional cirujano estadounidense que sirvió en el Cuerpo Médico del Ejército durante la Guerra Hispanoamericana. Durante la Primera Guerra Mundial fue director quirúrgico del American Ambulance Hospital de Neuilly (Francia). Ayudó a fundar el Colegio Americano de Cirujanos en 1913 y fue miembro y director no sólo de esta organización, sino también de la Asociación Médica Americana, la Asociación Quirúrgica Americana, la Real Academia de Cirujanos y la Real Academia de Medicina (Reino Unido). En 1921 fue cofundador de la Cleveland Clinic de Cleveland (Ohio, EE.UU.). Fue un importante médico cuyas investigaciones y escritos abarcaron el shock quirúrgico, la función glandular, la presión arterial y las transfusiones, la neurosis de guerra y los efectos de la cirugía en tiempos de guerra. También fue un cirujano extraordinario y prolífico que introdujo innovaciones en el tratamiento quirúrgico de muchas patologías. Aunque sus investigaciones se publicaron hace mucho tiempo, sus aportaciones a la medicina siguen siendo fundamentales para la práctica clínica en los quirófanos y unidades de cuidados intensivos actuales.

George W. Crile (1864-1943) was an exceptional American surgeon who served in the Army Medical Corps during the Spanish-American War. During the First World War, he was surgical director of the American Ambulance Hospital in Neuilly, France. He helped found the American College of Surgeons in 1913 and was a member and director not only of this organization, but also of the American Medical Association, the American Surgical Association, the Royal Academy of Surgeons and the Royal Academy of Medicine (UK). In 1921, he co-founded the Cleveland Clinic in Cleveland, Ohio, USA. He was an important physician whose research and writings included surgical shock, glandular function, blood pressure and transfusions, war neurosis and the effects of wartime surgery. He was also an extraordinary and prolific surgeon who introduced innovations in the surgical treatment of many pathologies. Although his research was published long ago, his contributions to medicine remain fundamental to clinical practice in today's operating rooms and intensive care units.

Long-term clinical outcomes following total knee arthroplasty in patients with hemophilic arthropathy: a single-surgeon cohort after a 10- to 17-year follow-up / 中华医学杂志(英文版)

BACKGROUND@#Total knee arthroplasty (TKA) can reduce severe joint pain and improve functional disability in hemophilia. However, the long-term outcomes have rarely been reported in China. Therefore, this study aimed to evaluate the long-term outcomes and complications of TKA in Chinese patients with hemophilic arthropathy.@*METHODS@#We retrospectively reviewed patients with hemophilia who underwent TKA between 2003 and 2020, with at least 10 years of follow-up. The clinical results, patellar scores, patients' overall satisfaction ratings, and radiological findings were evaluated. Revision surgery for implants during the follow-up period was recorded.@*RESULTS@#Twenty-six patients with 36 TKAs were successfully followed up for an average of 12.4 years. Their Hospital for Special Surgery Knee Score improved from an average of 45.8 to 85.9. The average flexion contracture statistically significantly decreased from 18.1° to 4.2°. The range of motion (ROM) improved from 60.6° to 84.8°. All the patients accepted patelloplasty, and the patients' patellar score improved from 7.8 preoperatively to 24.9 at the last follow-up. There was no statistically significant difference in clinical outcomes between the unilateral and bilateral procedures, except for a better ROM at follow-up in the unilateral group. Mild and enduring anterior knee pain was reported in seven knees (19%). The annual bleeding event was 2.7 times/year at the last follow-up. A total of 25 patients with 35 TKAs were satisfied with the procedure (97%). Revision surgery was performed in seven knees, with 10- and 15-year prosthesis survival rates of 85.8% and 75.7%, respectively.@*CONCLUSIONS@#TKA is an effective procedure for patients with end-stage hemophilic arthropathy, which relieves pain, improves knee functions, decreases flexion contracture, and provides a high rate of satisfaction after more than ten years of follow-up.

The beginnings and evolution of a pancreatic surgeon: a technical morphological analysis in first 5 years / 中华外科杂志

Objective: To explore the development of the pancreatic surgeon technique in a high-volume center. Methods: A total of 284 cases receiving pancreatic surgery by a single surgeon from June 2015 to December 2020 were retrospectively included in this study. The clinical characteristics and perioperative medical history were extracted from the medical record system of Zhongshan Hospital,Fudan University. Among these patients,there were 140 males and 144 females with an age (M (IQR)) of 61.0 (16.8) years(range: 15 to 85 years). The "back-to-back" pancreatic- jejunal anastomosis procedure was used to anastomose the end of the pancreas stump and the jejunal wall. Thirty days after discharge,the patients were followed by outpatient follow-up or telephone interviews. The difference between categorical variables was analyzed by the Chi-square test or the CMH chi-square test. The statistical differences for the quantitative data were analyzed using one-way analysis of variance or Kruskal-Wallis H test and further analyzed using the LSD test or the Nemenyi test,respectively. Results: Intraoperative blood loss in pancreaticoduodenectomy between 2015 and 2020 were 300,100(100),100(100),100(0),100(200) and 150 (200) ml,respectively. Intraoperative blood loss in distal pancreatectomy was 250 (375),100 (50),50 (65), 50 (80),50 (50),and 50 (100) ml,respectively. Intraoperative blood loss did not show statistical differences in the same operative procedure between each year. The operative time for pancreaticoduodenectomy was respectively 4.5,5.0(2.0),5.5(0.8),5.0(1.3),5.0(3.3) and 5.0(1.0) hours in each year from 2015 to 2020,no statistical differences were found between each group. The operating time of the distal pancreatectomy was 3.8 (0.9),3.0 (1.5),3.0 (1.8),2.0 (1.1),2.0 (1.5) and 3.0(2.0) hours in each year,the operating time was obviously shorter in 2018 compared to 2015 (P=0.026) and 2020 (P=0.041). The median hospital stay in 2020 for distal pancreatectomy was 3 days shorter than that in 2019. The overall incidence of postoperative pancreatic fistula gradually decreased,with a incident rate of 50.0%,36.8%,31.0%,25.9%,21.1% and 14.8% in each year. During this period,in a total of 3,6,4,2,0 and 20 cases received laparoscopic operations in each year. The incidence of clinically relevant pancreatic fistula (grade B and C) gradually decreased,the incident rates were 0,4.8%,7.1%,3.4%,4.3% and 1.4%,respectively. Two cases had postoperative abdominal bleeding and received unscheduled reoperation. The overall rate of unscheduled reoperation was 0.7%. A patient died within 30 days after the operation and the overall perioperative mortality was 0.4%. Conclusion: The surgical training of a high-volume center can ensure a high starting point in the initial stage and steady progress of pancreatic surgeons,to ensure the safety of pancreatic surgery.

How do young surgeons understand and grasp the new concepts, new techniques, and recent progress of hernia and abdominal wall surgery? / 中华外科杂志

With the development of modern surgery, the field of hernia and abdominal wall surgery is undergoing a transformative change, and new techniques, new concepts, and recent progress are being updated, which have motivated the high-quality development of the discipline. In the past two decades, the development of hernia and abdominal wall surgery in China has been recognized by international peers. Many young surgeons have gradually become the main force in the treatment of hernia and leaders in surgical technique. The innovation and development of discipline will never terminate; young surgeons as the main force should seriously think about how to improve their professional qualities. Young surgeons are interested in the innovation of surgical techniques and need to push for a traditional operation on the one hand and an innovative operation on the other. Updates to concepts and acquisition of new materials are more important, which can provide a solid foundation for technological innovation. Young surgeons should start with the basics and classics. Understanding the history and development of new techniques, new concepts and recent progress, and grasping indications of clinical application, is the important part of growing up for young surgeons, which can make surgical treatment more standardized, benefit patients, and promote the progress of Chinese specialized medical education.

Influence of postoperative complications on prognosis of gastric cancer-The manifestation of gastric surgeon's skill, responsibility and empathy / 中华胃肠外科杂志

Radical gastrectomy combined with perioperative comprehensive treatment is the main curable strategy for gastric cancer patients, and postoperative complications are the issue that gastric surgeons have to face. Complications not only affect the short-term postoperative recovery, but also facilitate tumor recurrence or metastasis, thus resulting in poor prognosis. Therefore, unifying the diagnostic criteria for postoperative complications, bringing the surgeons' attention to complications, and understanding the potential mechanism of complications undermining long-term survival, will be helpful to the future improvement of the clinical diagnosis and treatment as well as prognosis for gastric cancer patients in China. Meanwhile, surgeons should constantly hone their operative skills, improve their sense of responsibility and empathy, and administer individualized perioperative management based on patients' general conditions, so as to minimize the occurrence of postoperative complications and their influence on prognosis.

The effect of BMI and age on the outcomes of microsurgical vasoepididymostomy: a retrospective analysis of 181 patients operated by a single surgeon / 亚洲男科学杂志(英文版)

To design a treatment plan for patients with epididymal obstruction, we explored the potential impact of factors such as body mass index (BMI) and age on the surgical outcomes of vasoepididymostomy (VE). In this retrospective study, 181 patients diagnosed with obstructive azoospermia (OA) due to epididymal obstruction between September 2014 and September 2017 were reviewed. All patients underwent single-armed microsurgical intussusception VEs with longitudinal two-suture placement performed by a single surgeon (KH) in a single hospital (Peking University Third Hospital, Beijing, China). Six factors that could possibly influence the patency rates were analyzed, including BMI, age, mode of anastomosis, site of anastomosis, and sperm motility and quantity in the intraoperative epididymal fluid. Single-factor outcome analysis was performed via Chi-square test and multivariable analysis was performed using logistic regression. A total of 159 (87.8%, 159/181) patients were followed up. The follow-up time (mean ± standard deviation [s.d.]) was 27.7 ± 9.3 months, ranging from 12 months to 48 months. The overall patency rate was 73.0% (116/159). The multivariable analysis revealed that BMI and age significantly influenced the patency rate (P = 0.008 and 0.028, respectively). Younger age (≤28 years; odds ratio [OR] = 3.531, 95% confidence interval [95% CI]: 1.397-8.924) and lower BMI score (<26.0 kg m-2; OR = 2.352, 95% CI: 1.095-5.054) appeared to be associated with a higher patency rate. BMI and age were independent factors affecting the outcomes of microsurgical VEs depending on surgical expertise and the use of advanced technology.

Interpretation of the World Society of Emergency Surgery Guidelines for Diagnosis and Treatment of Acute Left Colonic Diverticulitis in the Elderly (2022 edition) / 中华外科杂志

Acute colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in the acute setting. Acute left colonic diverticulitis in the elderly presents with unique epidemiological features when compared with younger patients. Elderly patients have a lower risk of recurrent episodes, higher in-hospital and postoperative mortality. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) formulated the guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly (2022 edition). This article aims to interpret the guidelines statements on the following topics: diagnosis, management, non-surgical therapy and surgical technique.

Análisis estadístico de la práctica quirúrgica oncológica de piel, en nuestra especialidad / Statistical analysis of skin cancer surgical practice in our specialty

El cáncer de piel es el más frecuente de todos los tipos de cáncer del ser humano, por lo cual el conocimiento y diagnóstico correcto de la patología oncocutánea, así como la formación impartida a los especialistas de nuestra área, es de vital importancia a la hora de jerarquizar el diagnóstico temprano y lograr un adecuado tratamiento de forma oportuna. El correcto abordaje terapéutico del cáncer cutáneo y sus variantes es de primordial importancia en el manejo quirúrgico de los cirujanos plásticos, por lo cual la Comisión de Oncología Quirúrgica de tumores de piel de la Sociedad Argentina de Cirugía Plástica Estética y Reparadora (SACPER) decide realizar y difundir la siguiente encuesta anónima a los miembros de la SACPER. En esta encuesta evaluativa, se obtuvieron datos sobre el estado actual de formación de los cirujanos de nuestro país, la ejecución de las prácticas relacionadas con el abordaje, la resección o la reconstrucción posterior relacionados a dicha patología.

The knowledge and correct diagnosis of the oncocutaneous pathology, as well as the training provided to the specialists in our area, is of vital importance when prioritizing early diagnosis and achieving adequate treatment. The correct therapeutic approach to skin cancer and its variants is of paramount importance in the surgical management of plastic surgeons, for which we decided to carry out an anonymous survey of the members of the Argentine Society of Aesthetic and Reconstructive Plastic Surgery (SACPER). In this questionnaire, we obtained valuable information about the current state of training of surgeons in our country, the execution of practices related to the approach, resection, or subsequent reconstruction related to said pathology.

Expectativas y realización profesional en Cirugía General y subespecialidades quirúrgicas: situación actual de los cirujanos jóvenes en Córdoba / Expectations and professional fulfillment in general surgery and surgical sub-specialties: current situation of young surgeons in Cordoba

RESUMEN Antecedentes: en la Argentina, la especialidad Cirugía General se encuentra en crisis y esta situación alarmante se halla vinculada a las malas condiciones laborales del cirujano general. Objetivo: describir la percepción que el cirujano joven tiene al terminar su programa de formación, en relación con su perspectiva laboral, actividad quirúrgica y académica. Material y métodos: estudio transversal basado en una encuesta dirigida a cirujanos jóvenes en Córdoba, Argentina. Resultados: participaron 53 encuestados. El 58% eran hombres y la mediana de edad fue 32 años. El 72% ejercía Cirugía General y el 55% trabajaba en el sector privado. El 34% pertenecía a la Asociación de Cirugía de Córdoba y el 23% a la Asociación Argentina de Cirugía. En cuanto a la experiencia profesional, el 53,1% eran cirujanos junior y el 64% eran competentes para realizar procedimientos de baja o mediana complejidad. En relación con la perspectiva laboral, el 89% consideró que el cirujano joven no consigue salida laboral rápida y el 96,2% refirió que sus prácticas no eran bien remuneradas. Respecto de la calidad de vida personal y laboral, el 57% manifestó frustración e incertidumbre económica. En cuanto a las cirujanas, la tasa de inequidades de género y hostigamiento sexual en el ámbito laboral fue del 73% y 50%, respectivamente. Conclusión: encontramos la percepción de un bajo nivel de competencia para las cirugías de mayor complejidad y una baja tasa de adherencia a sociedades quirúrgicas. Debido a la escasa oferta laboral existe gran frustración e incertidumbre económica. Actualmente, predomina y persiste el maltrato y hostigamiento hacia las cirujanas.

ABSTRACT Background: In Argentina, the specialty of general surgery is in crisis, and this alarming situation is associated with the poor working conditions of general surgeons. Objective: The aim of this study is to describe the perception of young surgeons at the end of their training program, in relation to their job prospects, surgical and academic activity. Material and methods: We conducted a cross-sectional study based on a survey responded by young surgeons in Cordoba, Argentina. Results: The survey was responded by 53 young surgeons; 58% were men and median age was 32 years. Seventy-two percent practiced general surgery and 55% worked in the private setting. Thirtyfour percent were members of Asociación de Cirugía de Córdoba and 23% belonged to Asociación Argentina de Cirugía. As for professional experience, 53.1% were junior surgeons and 64% were capable of performing low or medium complexity procedures. Eighty-nine percent considered that young surgeons do not get a job quickly and 96.2% reported that they were not well paid for their practice. When asked about their personal and professional quality of life, 57% expressed frustration and economic uncertainty. Among women surgeons, 73% reported gender inequities and 50% reported sexual harassment in the workplace. Conclusion: Young surgeons perceived they had low level of competencies for high complexity surgical procedures and reported low rate of membership in surgical societies. Most of them feel frustrated due to scarce job opportunities and expressed economic uncertainty. Nowadays, abuse and harassment of women surgeons still prevails and persists.

Inteligencia emocional en residentes de Cirugía General: análisis de una encuesta nacional / Emotional intelligence among residents in general surgery: analysis of a national survey

RESUMEN Antecedentes: la inteligencia emocional (IE) es la capacidad de reconocer nuestros propios sentimientos y los de los demás, de motivarnos y de manejar adecuadamente las relaciones interpersonales. La IE se ha relacionado con muchas competencias no técnicas necesarias entre los médicos en formación. Objetivo: describir las características psicométricas de la IE en médicos residentes de Cirugía General de la Argentina y analizar los efectos que ejercen sobre ella la edad, el sexo, el ámbito de desempeño y el año de residencia. Material y métodos: estudio prospectivo, analítico de corte transversal; se utilizó la encuesta anónima y autogestionada Trait Emotional Intelligence Questionnaire Short Form (TEIQue-SF v1.5) respondida en línea durante el mes de marzo de 2020. Se aplicó la prueba de Kolmogorov-Smirnov para variables cuantitativas, pruebas T y la prueba ANOVA (IC 95%, p estadística α 0,05). Resultados: fueron respondidas 156 encuestas, de las cuales 105 (67,3%) corresponden a mujeres y 51 (32,7%) a hombres. Edad promedio: 29,02 ± 3,69 años. El promedio global de la prueba fue de 4,58 ± 0,89. El análisis ANOVA demostró que existen diferencias estadísticamente significativas de la dimensión bienestar entre los diferentes años de residencia (p = 0,002) así como en puntajes globales de IE (p = 0,0001). Conclusión: la IE es un modelo atractivo y eficaz para definir y capacitar a los futuros cirujanos generales en competencias no técnicas. Estos hallazgos son importantes para generar nuevas propuestas de formación.

ABSTRACT Background: Emotional intelligence (EI) is the ability to recognize our own feelings and those of others, to motivate us and properly manage relationships. EI encompasses many non-technical skills that are important for physicians in training. Objective: The aim of this study was to describe the psychometric characteristics of EI among residents in general surgery in Argentina and to analyze the effects of age, sex, scope of practice and postgraduate year level on it. Material and methods: We conducted a prospective, cross-sectional analytic study using the Trait Emotional Intelligence Questionnaire Short Form (TEIQue-SF v1.5), a self-report and anonymous survey that was answered on-line during March 2020. The statistical analysis was performed by using the Kolmogorov-Smirnov test for quantitative variables, Student's t-test and ANOVA (95% CI, p statistic α 0.05). Results: The survey was responded by 156 physicians; 105 (67.3%) were women and 51 (32.7%) were men (mean age: 29.02 ± 3.69 years). Mean global score was 4.58 ± 0.89. ANOVA showed statistically significant differences in the well-being dimension and global scores of EI across the different postgraduate year levels (p = 0.002 and p = 0.0001, respectively). Conclusion: EI is an attractive and effective model for defining and training future general surgeons in non-technical skills. These findings are important for generating new proposals for training.

Tendencias históricas en la formación de los cirujanos generales a nivel mundial / Historical trends about the training of general surgery specialists worldwide

Introducción: Los avances tecnológicos y educativos en ciencias médicas durante los últimos cincuenta años han sido mayores que en toda la historia de la humanidad. Objetivo: Caracterizar la formación del especialista de cirugía general en el mundo en su devenir histórico y actual. Métodos: Se hizo una revisión bibliográfica en las bases de datos CUMED, SciELO, LILACS, Web of Science y PubMed, mediante el motor de búsqueda de información Google Académico. Fueron seleccionados 23 artículos: 19 (82,6 por ciento) del quinquenio 2016-2020, publicados en español e inglés, concernientes al objetivo propuesto, para lo cual se aplicó el método teórico de investigación científica histórico-lógico. Desarrollo: A partir del siglo xix, la evolución de la cirugía en el mundo discurre desde sus limitaciones ocasionadas por el dolor, las infecciones, las hemorragias y el shock hasta el vertiginoso desarrollo de la anestesiología y la reanimación, la asepsia y antisepsia, los novedosos métodos de diagnóstico y tratamiento, la cirugía de trasplante de órganos y tejidos, la cirugía de mínimo acceso, la simulación y la robótica durante el siglo xx y en el presente. Conclusiones: Los avances educativos en la formación profesional durante el período de especialización en cirugía general no marchan al ritmo del desarrollo tecnológico a escala mundial. De ahí surge la necesidad de potenciar al máximo el proceso de enseñanza y aprendizaje de posgrado mediante el desarrollo de estos avances educativos, de manera que no queden a la zaga de los progresos tecnológicos(AU)

Introduction: Technological and educational advances in medical sciences during the last fifty years have been greater than in the entire history of humanity. Objective: To characterize the training of general surgery specialists worldwide considering its historical and current evolution. Methods: A bibliographic review was carried out in the databases CUMED, SciELO, LILACS, Web of Science and PubMed, using the search engine Google Scholar. Twenty-three articles were selected: 19 (82.6 percent) from the five-year period 2016-2020, published in Spanish and English, concerning the set objective, for which the theoretical method of historical-logical scientific research was applied. Development: From the 19th century on, the evolution of surgery worldwide goes from its limitations caused by pain, infections, bleeding and shock to the dizzying development, during the twentieth century and nowadays, of anesthesiology and resuscitation, asepsis and antisepsis, novel methods for diagnosis and treatment, organ and tissue transplant surgery, minimal access surgery, simulation and robotics. Conclusions: Educational advances in professional training during the period of specialization in general surgery do not go in step with technological development on a global scale, hence the need to maximize the postgraduate teaching and learning process through the development of these educational advances, in order for them not to be left behind technological progress(AU)

Avaliação do Conhecimento e Aplicação de Critérios Abordados em Protocolos de Condutas Perioperatórias para Recuperação Acelerada por Médicos Cirurgiões / Assesment of the Surgeons' Knowledge and Application of Enhanced Recovery after Surgery Protocols

Introdução: Pacientes submetidos a procedimentos cirúrgicos estão sujeitos a complicações cirúrgicas e decorrentes de longos períodos de internação. Programas que visam melhorar os desfechos cirúrgicos e abreviar o tempo de permanência hospitalar foram criados e otimizados com intuito de reduzir essas complicações e custos relacionados. Devido à complexidade do tema, da implantação dos protocolos e das alterações de práticas já consolidadas, esses protocolos ainda não são totalmente colocados em prática pelos profissionais da área. Objetivo: Avaliar o conhecimento e a aplicabilidade dos médicos cirurgiões, acerca de aspectos abordados em programas de recuperação pós-operatória acelerada. Materiais: Estudo observacional descritivo, transversal, com coleta de dados primários. Resultados: Dos entrevistados, 82,9% eram homens, com idade média de 43,07 anos. Destes, 81,1% não utilizam fórmulas para calcular individualmente a reposição de volume perioperatório. Em relação ao uso de drenos no sítio operatório, 55,7% dos participantes relataram fazer uso rotineiro, e 91,7% referiram orientar a retirada do mesmo após pelo menos 3 dias. Quanto ao jejum pré-operatório para sólidos, 40,4% e 34,2% dos cirurgiões consideram 6 e 8 horas como o tempo mínimo adequado, respectivamente, sendo que 62,7% dos entrevistados disseram reintroduzir a dieta por via oral de acordo com protocolos predeterminados. Conclusão: Os protocolos de recuperação acelerada são amplamente embasados em evidências e comprovados através de estudos científicos, e alguns dos aspectos por eles defendidos já são colocados em prática por boa parte dos cirurgiões em atuação. Porém, é possível perceber que alguns aspectos ainda precisam de maior aceitação por parte dos médicos.

Introduction: Patients undergoing surgical procedures are subject to surgical complications and resulting from long hospital stays. Programs aimed at improving surgical outcomes and shortening hospital stay were created and optimized in order to reduce these complications and related costs. Due to the complexity of the topic, of the implementation of protocols and changes in practices that have already been consolidated, these protocols are still not fully put into practice by professionals in the field. Objective: To evaluate surgeons' knowledge and applicability of aspects addressed in accelerated postoperative recovery programs. Materials and methods: A descriptive, cross-sectional observational study with primary data collection. Results: Of the respondents, 82.9% were men, with a mean age of 43.07 years. Of these, 81.1% do not use formulas to individually calculate perioperative volume replacement. Regarding the use of drains in the operative site, 55.7% of the participants reported using it routinely, and 91.7% reported advising to remove it after at least 3 days. As for preoperative fasting for solids, 40.4% and 34.2% of surgeons consider 6 and 8 hours as the minimum adequate time, respectively, and 62.7% of respondents reported reintroducing the diet orally according to predetermined protocols. Conclusion: Accelerated recovery protocols are largely based on evidence and proven through scientific studies and some of the aspects defended by them are already put into practice by most practicing surgeons. However, it is possible to see that some aspects still need greater acceptance by doctors.

Tendencias históricas en la formación de los cirujanos generales a nivel mundial / Historical trends about the training of general surgery specialists worldwide

Introducción: Los avances tecnológicos y educativos en ciencias médicas durante los últimos cincuenta años han sido mayores que en toda la historia de la humanidad. Objetivo: Caracterizar la formación del especialista de cirugía general en el mundo en su devenir histórico y actual. Métodos: Se hizo una revisión bibliográfica en las bases de datos CUMED, SciELO, LILACS, Web of Science y PubMed, mediante el motor de búsqueda de información Google Académico. Fueron seleccionados 23 artículos: 19 (82,6 por ciento) del quinquenio 2016-2020, publicados en español e inglés, concernientes al objetivo propuesto, para lo cual se aplicó el método teórico de investigación científica histórico-lógico. Desarrollo: A partir del siglo xix, la evolución de la cirugía en el mundo discurre desde sus limitaciones ocasionadas por el dolor, las infecciones, las hemorragias y el shock hasta el vertiginoso desarrollo de la anestesiología y la reanimación, la asepsia y antisepsia, los novedosos métodos de diagnóstico y tratamiento, la cirugía de trasplante de órganos y tejidos, la cirugía de mínimo acceso, la simulación y la robótica durante el siglo xx y en el presente. Conclusiones: Los avances educativos en la formación profesional durante el período de especialización en cirugía general no marchan al ritmo del desarrollo tecnológico a escala mundial. De ahí surge la necesidad de potenciar al máximo el proceso de enseñanza y aprendizaje de posgrado mediante el desarrollo de estos avances educativos, de manera que no queden a la zaga de los progresos tecnológicos(AU)

Introduction: Technological and educational advances in medical sciences during the last fifty years have been greater than in the entire history of humanity. Objective: To characterize the training of general surgery specialists worldwide considering its historical and current evolution. Methods: A bibliographic review was carried out in the databases CUMED, SciELO, LILACS, Web of Science and PubMed, using the search engine Google Scholar. Twenty-three articles were selected: 19 (82.6percent) from the five-year period 2016-2020, published in Spanish and English, concerning the set objective, for which the theoretical method of historical-logical scientific research was applied. Development: From the 19th century on, the evolution of surgery worldwide goes from its limitations caused by pain, infections, bleeding and shock to the dizzying development, during the twentieth century and nowadays, of anesthesiology and resuscitation, asepsis and antisepsis, novel methods for diagnosis and treatment, organ and tissue transplant surgery, minimal access surgery, simulation and robotics. Conclusions: Educational advances in professional training during the period of specialization in general surgery do not go in step with technological development on a global scale, hence the need to maximize the postgraduate teaching and learning process through the development of these educational advances, in order for them not to be left behind technological progress(AU)

Cirujano académico, centro académico: su rol docencia, investigación y en la atención de pacientes / The academic surgeon, academic center: its teaching, research, and patient's assistance role

Resumen Un cirujano académico tiene características y atributos especiales que lo distinguen de otros cirujanos. Su misión no es solo asistencial, sino que además es un investigador, docente, comunicador, deber ejercer liderazgo, debe ser innovador. Además de su función primordial que es ofrecer la óptima atención de sus pacientes. Al estar inserto en un centro académico cumple estas funciones y se convierte, dado su prestigio, en un referente individual e institucional para la comunidad y los futuros cirujanos.

An academic surgeon has special characteristics and attributes that distinguish them from other surgeons. His mission is not only healthcare, but he is also a researcher, teacher, communicator, must exercise leadership, must be innovative and the final goal is his work is to offer optimal care for his patients. Being inserted in an academic center, it fulfills these functions and becomes, given its prestige, an individual and institutional reference for the community and future.

La Sociedad de Cirugía del Uruguay y la escuela quirúrgica francesa: un vínculo centenario / The Society of Surgery of Uruguay and the French surgical school: a centenary bond / A Sociedade de Cirurgia do Uruguai e a escola cirúrgica francesa: um vínculo centenário

La historia de la cirugía y de las escuelas quirúrgicas está construida sobre el conocimiento médico, pero también influenciada por las grandes corrientes de pensamiento políticas, religiosas, culturales e incluso militares de las diferentes épocas. La influencia de la cirugía francesa en la formación de la escuela quirúrgica uruguaya, a lo largo de más de un siglo ha sido determinante para establecer sus bases desde la evidencia clínica, el dominio de la anatomía, la excelencia técnica, un permanente espíritu crítico para impulsar la generación de nuevos conocimientos; todo basado una ética guiada por el máximo respeto por el paciente y su sufrimiento. El presente trabajo, analiza desde la perspectiva de la cirugía general los primeros contactos quirúrgicos durante la Guerra Grande, el inicio de la formación académica de los cirujanos uruguayos en Francia, los aspectos técnicos y las publicaciones relevantes producto de esas experiencias; así como anécdotas y amistades personales e institucionales sobre las que se fue construyendo un sólido modelo de relacionamiento científico especialmente a través de la Sociedad de Cirugía del Uruguay.

The history of surgery and surgical schools were built on the basis of medical knowledge, but also influenced by the great currents of political, religious, cultural and even military thought of the different times. The influence of the French surgical school in the development of surgery in Uruguay, for more than a century, has been decisive in establishing its pillars: clinical evidence, expertise in anatomy, technical excellence, a permanent critical analysis for promote the generation of knowledge; based on ethics principles of respect for the patient and his suffering. The present study analyzes, from the perspective of the general surgery, the first surgical contacts during the first civil war, the beginning of the academic training of Uruguayan surgeons in France, the technical aspects and the relevant publications resulting from these experiences; as well as anecdotes and personal and institutional friendships on which a solid model of scientific relationship was built, especially through the Uruguay Society of Surgery.

A história da cirurgia e das escolas cirúrgicas é construída no saber médico, mas também influenciada pelas grandes correntes do pensamento político,religioso, cultural, e até militar das diferentes épocas.A influência da cirurgia francesa na formação da escola cirúrgica uruguaia, ao longo de mais de um século, foi decisiva para estabelecer suas bases a partir de evidências clínicas, domínio da anatomia, excelência técnica, espírito crítico permanente para promover a geração de novos conhecimentos; tudo baseado em uma ética pautada no máximo respeito pelo paciente e seu sofrimento.O presente trabalho analisa, sob a ótica da cirurgia geral, os primeiros contatos cirúrgicos durante a grande guerra, o início da formação acadêmica dos cirurgiões uruguaios na França, os aspectos técnicos e as publicações relevantes resultantes dessas experiências; assim como anedotas e amizades pessoais e institucionais sobre as quais se construiu um sólido modelo de relacionamento científico, especialmente por meio da Sociedade de Cirurgia do Uruguai