Trends in General Surgery Resident Experience with Colorectal Surgery: An Analysis of the Accreditation Council for Graduate Medical Education Case Logs.

Autor: Kling SM; Department of General Surgery, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania., Raman S; Department of General Surgery, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania., Taylor GA; Department of General Surgery, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania., Philp MM; Department of General Surgery, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania., Poggio JL; Department of General Surgery, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania., Dauer ED; Department of General Surgery, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania., Oresanya LB; Department of General Surgery, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania., Ross HM; Department of General Surgery, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania., Kuo LE; Department of General Surgery, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania. Electronic address: lindsay.kuo@tuhs.temple.edu.
Jazyk: angličtina
Zdroj: Journal of surgical education [J Surg Educ] 2022 May-Jun; Vol. 79 (3), pp. 632-642. Date of Electronic Publication: 2022 Jan 19.
DOI: 10.1016/j.jsurg.2021.12.009
Abstrakt: Objective: Colorectal surgery is a core component of general surgery. The volume of colorectal surgery performed by general surgery residents throughout training has not been studied. This study aims to analyze trends observed in colorectal-specific case numbers logged by general surgery residents over 16 years.
Design: Case number data for general surgery residents was extracted from the publicly available, annually published Accreditation Council for Graduate Medical Education (ACGME) database from 2003 to 2019. Cases were categorized as open or laparoscopic colectomy/proctectomy, colectomy with ileoanal pull-thru, abdomino-perineal resection (APR), transanal rectal tumor excision (TRE), anorectal procedure, colonoscopy, and total colorectal cases. The average case numbers per category was calculated for each year. Linear regression analyzed trends in case categories for all residents and those logged as surgeon chief and junior residents.
Setting: ACGME accredited general surgery residency programs.
Participants: Not applicable.
Results: General surgery residents reported increased numbers of all, chief, and junior resident colorectal cases over the study period (124.5-173.7 cases/yr; 38.4-53.0 cases/yr; 86.4-120.6 cases/yr, all p = 0.00). Average cases for all, chief, and junior residents have increased for laparoscopic colectomy/proctectomy (4.6-26.4 cases/year; 2.7-12.9 cases/year; 2.0-13.5 cases/year, all p = 0.00), anorectal surgeries (26.7-37.7 cases/year; 5.4-9.9 cases/year; 21.3-27.8 cases/year, all p = 0.00), and colonoscopies (35.9-70.6 cases/year, p = 0.00; 6.6-14.1 cases/year, p = 0.01; 29.4-56.5 cases/year, p = 0.00). Average cases for all, chief, and junior residents have decreased for open colectomy/proctectomy (52.0-34.9 cases/year; 21.2-14.3 cases/year; 30.9-20.6 cases/year, all p = 0.00), APR (3.3-2.7 cases/year, p = 0.00; 1.8-1.3 cases/year, p = 0.00; 1.5-1.4 cases/year, p = 0.02), TRE (1.9-1.1 cases/year; 0.7-0.4 cases/year; 1.2-0.6 cases/year, all p = 0.00). Ileoanal pull-thru did not demonstrate a linear trend.
Conclusions: The increase in exposure to colectomies/proctectomies, anorectal procedures and colonoscopies is encouraging, as these common colorectal operations will be encountered in general surgery practice. The observed low case numbers for TRE, APR, and ileoanal pull-thru suggest a need for specialized training.
(Copyright © 2021 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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