Anatomical Disregard as a Risk Factor in Thoracic Surgery.

The anatomy plays a significant role in medical education, allowing a progressive appropriate professional development. Because of different factors adverse events (AE) occur, where patient’s safety is achieved by surgical knowledge, prevention and elimination of risk factors. Absence or incorrect knowledge of the anatomical basis at the beginning of the graduate studies specialization are factors that alter the surgical patient’s safety, risking his life. The safety checklist in surgery is used to reduce avoidable risks for the patient in the operating room.Objectives: 1. Analyze the anatomic disregard as a risk factor in surgical anatomical processes of the thorax. 2. Evaluate actions to provide greater safety for the patient with thoracic surgical pathology. 3. Evaluate the importance of implementing register systems to improve the quality of care and patient’s safety with thoracic surgical pathology.Retrospective statistical analysis of anatomic disregard as a risk factor contributing to adverse events (AEs) in anatomical and surgical procedures of the thorax was performed in the General Surgery Service of the Hospital Aeronáutico Central of Buenos Aires Air (HAC), from October 2009 to April 2011; and a case of anatomical disregard and its clinical-surgical implications was reported, in General Surgery Service of Hospital de Clínicas of Buenos Aires.In the General Surgery Service of HAC, 21 patients (17.64%) had AE all (100%) preventable. 100% were due to human factors, corresponding to 12 (57.14%), because of ignorance of anatomical region and the rest by other factors: absence of checklist in 7 (58.33%) of which 5 (71.43%) correspond to the first 9 months of the studied period and 2 (28.57%) in the next 9 months. A case of anatomical disregard was reported in the surgical practice of General Surgery Service of Hospital de Clínicas, Buenos Aires where it was because of complications that endangered the patient’s life.The registration systems are a starting point to improve a system of quality and patient’s safety. The analysis of contributing factors (such as ignorance of thorax anatomy by the surgeon), register or report adverse events occurred in thoracic surgical procedures are used to prevent and reduce risk. The reduction of preventable risks is present using the checklist, however some more detailed items about the need for knowledge of the anatomy of the thorax could be added to further improve efficiency. The continuing medical education about anatomical knowledge for the surgeons, must be stimulated and promoted during their training.