Supervised independence in elective inguinal hernia repairs performed by surgical residents is not associated with compromised short clinical outcome or rates of reoperation for recurrence
| Autor: | Marshall S. Baker, Celsa M. Tonelli, Corinne Bunn, Zaid M. Abdelsattar, Sonya P. Agnew, Tyler D. Cohn, Isabela L. Lorenzo, Frederick A. Luchette, Sujay Kulshrestha |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Reoperation
medicine.medical_specialty Surgical approach business.industry General surgery Patient demographics Internship and Residency Hernia Inguinal General Medicine Standard methods medicine.disease Acs nsqip Inguinal hernia Treatment Outcome Recurrence medicine Unilateral inguinal hernia Humans Surgery Laparoscopy Postgraduate level business Complication Herniorrhaphy Retrospective Studies |
| Zdroj: | American journal of surgery. 223(3) |
| ISSN: | 1879-1883 |
| Popis: | Background We evaluate the association between attending surgeon involvement and clinical outcome in elective inguinal hernia repairs performed by residents. Methods Patients undergoing initial elective unilateral inguinal hernia repair between 2004 and 2019 were identified using the Veterans Administration Surgical Quality Improvement Program Database. The level of attending surgeon involvement was categorized as active (attending scrubbed [AS]) or passive (supervising the resident's performance but not scrubbed [ANS]). AS and ANS herniorrhaphies were 1:1 propensity matched for patient demographics, comorbidities, surgical approach, resident postgraduate level, and year of repair. Rates of complication and recurrence for matched cohorts were compared by standard methods. Results 30,784 patients met inclusion criteria. 5136 (17%) repairs were performed without the attending scrubbed. On comparison of matched-cohorts, overall complication rates (1.7% vs 1.2%, p = 0.07) and rates of recurrence (1.9% vs 1.4%, p = 0.041) for patients undergoing herniorrhaphy AS were statistically similar to those performed ANS. Conclusion Supervised independence in elective inguinal hernia repair performed by surgical residents is not associated with inferior clinical outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect