Laparoscopic appendectomy - Outcomes of senior trainees operating without supervision versus experienced pediatric surgeons.
Adolescent
Appendectomy
/ adverse effects
Appendicitis
/ surgery
Child
Child, Preschool
Clinical Competence
Humans
Intraoperative Complications
/ etiology
Laparoscopy
/ adverse effects
Length of Stay
Operative Time
Patient Readmission
Pediatrics
/ education
Reoperation
Retrospective Studies
Specialties, Surgical
/ education
Young Adult
Fellowship training
Laparoscopic appendectomy
Surgical independence
Trainee autonomy
Journal
Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
18
10
2018
accepted:
30
10
2018
pubmed:
7
12
2018
medline:
4
4
2019
entrez:
4
12
2018
Statut:
ppublish
Résumé
Pediatric surgery trainees at our program are allowed to perform unsupervised laparoscopic appendectomies during their last year of training to promote independent operative decision-making skills. We reviewed the outcomes of laparoscopic appendectomies done by senior trainees without supervision and compared them to experienced pediatric surgeons. We reviewed 500 laparoscopic appendectomies performed without supervision by the last 10 pediatric surgery trainees during their last year of training (first 50 cases of each trainee). We compared the outcomes of those 500 cases to the outcomes of 200 laparoscopic appendectomies performed by eight experienced pediatric surgeons (last 25 cases of each surgeon). Data are expressed as mean (SD), unless otherwise indicated. A P value of ≤0.05 was regarded as significant. Median age in the "trainees" and "surgeons" groups was 11 (range 2-22) and 12 (2-20) years, respectively (P = 0.35). The proportion of perforated appendicitis was similar: 98/500 (19.6%) in the trainees group and 42/200 (21%) in the surgeons group, respectively (P = 0.75). Mean operative time was 41 (SD 14.5) min in the trainees group vs. 39 (SD 16.1) min in the surgeons group (P = 0.05). Minor intraoperative complications occurred in 3/500 (0.6%) cases in the trainees group vs. 1/200 (0.5%) in the surgeons group (P = 0.69). No major complications occurred in either group. Mean hospital stay was 2 (range 0.5-26) and 2.3 (range 0.5-18) days in the trainees and surgeons groups, respectively (P = 0.25). There were 13/500 vs. 5/200 readmissions (P = 0.92), and 1/500 vs. 1/200 reoperations in the trainees and surgeons groups, respectively (P = 0.91). Allowing senior pediatric surgery trainees to perform laparoscopic appendectomies without supervision to stimulate surgical autonomy is safe and does not compromise patient outcomes. III.
Identifiants
pubmed: 30502007
pii: S0022-3468(18)30752-8
doi: 10.1016/j.jpedsurg.2018.10.092
pii:
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
276-279Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.