Resident Involvement in Radical Inguinal Orchiectomy for Testicular Cancer Does Not Adversely Impact Perioperative Outcomes - A Retrospective Study.

Autor:	Vetterlein MW; Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass., USA., Seisen T, Löppenberg B, Hanna N, Cheng PJ, Fisch M, Chun FK, Kibel AS, Preston MA, Meyer CP
Jazyk:	angličtina
Zdroj:	Urologia internationalis [Urol Int] 2017; Vol. 98 (4), pp. 472-477. Date of Electronic Publication: 2016 Aug 31.
DOI:	10.1159/000448596
Abstrakt:	Introduction: To evaluate perioperative outcomes related to resident involvement (RI) in a large and prospectively collected multi-institutional database of patients undergoing orchiectomy for testicular cancer. Materials and Methods: Using current procedural terminology and ICD-9 codes, information about patients with testicular cancer were abstracted from the American College of Surgeons National Surgical Quality Improvement Program database (2006-2013). Multivariable analyses evaluated the impact of RI on outcomes after orchiectomy. Prolonged operative time (pOT) and prolonged length of stay were defined by the 75th percentile (59 min) and postoperative inpatient stay ≥2 days, respectively. Results: Overall, 267 patients underwent orchiectomy either with (38.6%) or without (61.4%) RI. In all, 89.1% of patients underwent an outpatient procedure. The median body mass index was 26.8 and baseline characteristics between the 2 groups were similar. Overall complications, re-intervention, and bleeding-related complication rates were 2.6, 0.7, and 0.4%, respectively. Although there was no difference in terms of overall complications between the groups (3.9 vs. 1.8%; p = 0.44), RI resulted in pOT (32 vs. 19.5%; p = 0.028). In multivariable analyses, RI predicted pOT (OR 1.89, 95% CI 1.06-3.37; p = 0.031), without association with prolonged length of stay and overall complications. Conclusions: RI during orchiectomy for testicular cancer does not undermine patient safety at the cost of pOT. (© 2016 S. Karger AG, Basel.)
Databáze:	MEDLINE
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