This study intended to identify the need for the legalization and development of a systematic program for physician assistants (PAs) by understanding the actual state of PA operation in hospitals. In 114 hospitals assigned as resident training hospitals for surgery, a survey was conducted on the personnel working as PAs in those hospitals; the survey included general personal information, working conditions, training time, and satisfaction. A total of 192 PAs in surgery at 35 hospitals responded to the survey. The types of PAs are Surgical Assistant, Clinical Physician Assistant, Wound Ostomy Care Nurse, Coordinator, and Clinical Research Coordinator. Types of work PAs preformed are surgical assistance, wound dressing, educating patients, overlooking consultation, doing paper works, writing operation records, and confirming examination results which were ordered. The satisfaction level for the position which PAs hold were 29.1% and and satisfaction level which doctors see towards PA was 15%. The role and the job descriptions of PAs are not clear cut, there are many discrepancies among hospitals we studied. As a result, legalization and the implementation of standardized role of PAs will lead to increase level of satisfactions in the work force and the quality of work which PAs perform will be greater.
Purpose: Laparoscopic appendectom y is a com m on procedure for treatm ent of appendicitis. H ow ever, in som e com plicated cases, like periappendiceal abscess, deciding on treatm ent options is very challenging. Early appendectom y or interval appendectom y m ay be possible, but rem ains controversial.Methods: W e prospectively studied the advantages of interval appendectom y in 21 patients w ith periappendiceal abscess using a laparoscopic m ethod versus 14 patients w ith im m ediate initial laparotom y.Results: In the interval appendectom y group (IN T group), in periappendiceal abscess, use of a laparoscopic m ethod w as advantageous in term s of operation tim e (p<0.001), less fasting tim e (p<0.001), and few er postoperative com plications (p= 0.032). H ow ever, the total cost in the IN T group w as 1,686,000±940,000 South Korean w on (KRW ) com pared w ith 1,506,000± 322,000 KRW in the early appendectom y group (EAR group) (p= 0.007) because patients in the IN T group required tw o hospital visits. The total length of hospital stay postoperatively, w as 7.31±2.726 days in the INT group, compared w ith 9.21± 3.378 days in the EAR group (p= 0.537).Conclusion: W e recom m end interval appendectom y as the preferable approach for the periappendiceal abscess, as it can result in m ore favorable postoperative surgical outcom es, fewer com plications, and less antibiotic usage.
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