Document Detail


Outcomes associated with resident involvement in partial colectomy.
MedLine Citation:
PMID:  23303150     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
James C Iannuzzi; Aaron S Rickles; Andrew-Paul Deeb; Abhiram Sharma; Fergal J Fleming; John R T Monson
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  56     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  212-8     Citation Subset:  IM    
Affiliation:
Surgical Health Outcomes & Research Enterprise, University of Rochester Medical Center, Rochester, New York.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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