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Dis Colon Rectum. 2013 Feb;56(2):212-8. doi: 10.1097/DCR.0b013e318276862f.

Outcomes associated with resident involvement in partial colectomy.

Author information

1
Surgical Health Outcomes & Research Enterprise, University of Rochester Medical Center, Rochester, New York 14642, USA. james_iannuzzi@urmc.rochester.edu

Abstract

BACKGROUND:

Surgical cases that include trainees are associated with worse outcomes in comparison with those that include attending surgeons alone.

OBJECTIVE:

This study aimed to identify whether resident involvement in partial colectomy was associated with worse outcomes when evaluated by surgical approach and resident experience.

DESIGN:

This is a retrospective study using the National Surgical Quality Improvement Program database.

SETTINGS:

This study evaluates cases included in the National Surgical Quality Improvement Program database.

PATIENTS:

All patients were included who underwent partial colectomy including both open and laparoscopic approaches.

INTERVENTIONS:

Residents were involved.

MAIN OUTCOME MEASURES:

The primary outcome measures were the association of resident involvement and major complication events, minor complication events, unplanned return to operating room, and operative time.

RESULTS:

Cases with residents were associated with major complications (OR 1.18, CI 1.09-1.27, p < 0.001) on multivariate analysis. However, after including operative time in the model only open cases involving fifth year residents were still associated with major complications (OR 1.13, p = 0.037). Resident involvement was associated with increased likelihood of minor complications (OR 1.3, p < 0.001) and an increased risk of unplanned return to the operating room (OR 1.20, p < 0.001). Operative time was longer for cases with residents on average by 33.7 minutes and 27 minutes for open and laparoscopic cases.

LIMITATIONS:

This study was limited by its retrospective design and lack of data on teachings status, case complexity, and intraoperative evaluation of technique.

CONCLUSIONS:

Resident involvement in partial colectomies is associated with an increased major complications, minor complications, likelihood of return to the operating room, and operative time.

PMID:
23303150
DOI:
10.1097/DCR.0b013e318276862f
[Indexed for MEDLINE]

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