Cranioplasty: is surgical education safe?
| Autor: | Gerhard Hildebrandt, Lukas Sveikata, Holger Joswig, Karl Lothard Schaller, Oliver Gautschi, Amir El Rahal, Andrea Bartoli, Martin N. Stienen |
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| Přispěvatelé: | University of Zurich, Stienen, Martin N |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Neurosurgery 610 Medicine & health 03 medical and health sciences Patient safety 10180 Clinic for Neurosurgery Postoperative Complications 0302 clinical medicine Modified Rankin Scale medicine Humans Craniotomy Retrospective Studies business.industry Internship and Residency Postoperative complication Retrospective cohort study Middle Aged Cranioplasty ddc:616.8 Surgery 2746 Surgery 2728 Neurology (clinical) 030220 oncology & carcinogenesis Female Neurology (clinical) Complication business 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery, Vol. 91 (2016) pp. 81-88 |
| ISSN: | 1878-8750 |
| Popis: | Patient safety aspects and the residents' role in spine surgery within a structured training program have recently been investigated. The current work deals with residency training safety aspects for cranioplasty (CP), a standard neurosurgical cranial procedure.Retrospective 2-center study comparing consecutive patients undergoing CP by a supervised neurosurgery resident (teaching cases) with a consecutive series of patients operated on by a board-certified faculty neurosurgeon (nonteaching cases). The primary end point was occurrence of a postoperative complication. Secondary end points were severity (Ibañez degree) of postoperative complications, surgical site infections requiring CP removal and patients' clinical outcome measured with the modified Rankin Scale.A total of 240 CPs (137 teaching [57.1%] and 103 nonteaching [42.9%] cases) were analyzed. The mean teaching case operation time was longer (129.2 vs. 115.8 minutes; P0.001), and there was no difference in the estimated blood loss (mean 243.3 vs. 223.1 mL; P = 0.444). Supervised residents were as likely as board-certified faculty neurosurgeons to have a postoperative complication (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.42-1.39; P = 0.385) and the severity was comparable (Pearson χ(2) = 7.62; P = 0.106). Teaching cases were as likely as nonteaching cases to experience a surgical site infection requiring CP removal (OR, 1.66; 95% CI, 0.69-4.04; P = 0.261). Also, the likelihood for postoperative improvement on the modified Rankin Scale was similar for patients in both groups (OR, 1.11; 95% CI, 0.62-2.00; P = 0.719).A relatively simple cranial procedure, such as CP, can be safely performed by a supervised neurosurgery resident without increasing complications or compromising patients' outcomes. |
| Databáze: | OpenAIRE |
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