Comparison of perioperative outcomes of emergency hartmann resections performed by residents versus attending surgeons.

Autor: Orbach L; Division of Surgery, Tel Aviv Sourasky Medical Center and Tel Aviv University, Israel; Tel Aviv University, Faculty of Medical & Health Sciences, Israel. Electronic address: lior.orbach@gmail.com., Gabay S; Division of Surgery, Tel Aviv Sourasky Medical Center and Tel Aviv University, Israel., Montekio T; Division of Surgery, Tel Aviv Sourasky Medical Center and Tel Aviv University, Israel., Chai AS; Tel Aviv University, Faculty of Medical & Health Sciences, Israel., Kariv Y; Division of Surgery, Tel Aviv Sourasky Medical Center and Tel Aviv University, Israel; Colorectal Service, Tel Aviv Sourasky Medical Center and Tel Aviv University, Israel; Tel Aviv University, Faculty of Medical & Health Sciences, Israel., Zemel M; Division of Surgery, Tel Aviv Sourasky Medical Center and Tel Aviv University, Israel; Colorectal Service, Tel Aviv Sourasky Medical Center and Tel Aviv University, Israel; Tel Aviv University, Faculty of Medical & Health Sciences, Israel., Abu-Abeid A; Division of Surgery, Tel Aviv Sourasky Medical Center and Tel Aviv University, Israel; Tel Aviv University, Faculty of Medical & Health Sciences, Israel., Lahat G; Division of Surgery, Tel Aviv Sourasky Medical Center and Tel Aviv University, Israel; Tel Aviv University, Faculty of Medical & Health Sciences, Israel., Yuval JB; Division of Surgery, Tel Aviv Sourasky Medical Center and Tel Aviv University, Israel; Colorectal Service, Tel Aviv Sourasky Medical Center and Tel Aviv University, Israel; Tel Aviv University, Faculty of Medical & Health Sciences, Israel.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Nov 13; Vol. 240, pp. 116084. Date of Electronic Publication: 2024 Nov 13.
DOI: 10.1016/j.amjsurg.2024.116084
Abstrakt: Objective: The optimal level of resident autonomy in emergency colorectal surgery is unclear. This study assessed perioperative outcomes in patients undergoing emergency colectomy with end stoma based on the presence of an attending surgeon.
Participants: A retrospective analysis was conducted at a tertiary teaching hospital, including 360 patients who underwent emergency colectomy with end stoma between 2013 and 2023. The primary outcome was perioperative complications, including mortality.
Results: Of the 360 patients, 36 (10 ​%) had surgery without an attending surgeon present. Baseline characteristics such as age (p ​= ​0.34), Charlson Comorbidity Index (p ​= ​0.313), and sex (p ​= ​0.598) were similar across groups. Perioperative outcomes showed no significant differences in major complications (Clavien-Dindo ≥3, p ​= ​0.176), 90-day complication rate (p ​= ​0.698), or 90-day mortality (p ​= ​0.389). Malignancy-related cases also did not differ in lymph node yield (p ​= ​0.685) or overall survival (log-rank p ​= ​0.574).
Conclusion: In this study, Hartmann resections performed by resident teams were not associated with worse perioperative or oncologic outcomes, suggesting that resident autonomy can be safely increased without compromising patient safety.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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