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Laparoscopic append...
Laparoscopic appendectomy as an index procedure for surgical trainees: clinical outcomes and learning curve
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Ussia, A. (author)
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Vaccari, S. (author)
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Gallo, G. (author)
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Grossi, U. (author)
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Ussia, R. (author)
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Sartarelli, L. (author)
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Minghetti, M. (author)
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Lauro, A. (author)
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- Barbieri, Paolo Nicola (author)
- Gothenburg University,Göteborgs universitet,Centrum för hälsoekonomi (CHEGU),Centre for Health Economics
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Di Saverio, S. (author)
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Cervellera, M. (author)
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Tonini, V. (author)
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(creator_code:org_t)
- 2021-01-04
- 2021
- English.
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In: Updates in Surgery. - : Springer Science and Business Media LLC. - 2038-131X .- 2038-3312. ; 73, s. 187-195
- Related links:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Surgical training is essential to maintain safety standards in healthcare. The aim of this study is to evaluate learning curves and short-term postoperative outcomes of laparoscopic appendectomy (LA) performed by trainees (TRN) and attendings (ATT). The present study included the medical records of patients with acute appendicitis who underwent a fully LA in our department between January 2013 and December 2018. Cases were divided into trainees (TRN and ATT groups based on the experience of the operating surgeon. The primary outcome measures were 30-day morbidity and mortality. Preoperative patients' clinical characteristics, intraoperative findings, operative times, and postoperative hospitalization were compared. Operative times were used to extrapolate learning curves and evaluate the effects of changes in faculty using CUSUM charts. A propensity score matching analysis was performed to reduce differences between cohorts regarding both preoperative characteristics and intraoperative findings. A total of 1173 patients undergoing LA for acute appendicitis were included, of whom 521 (45%) in the TRN group and 652 (55%) in the ATT group. No significant differences were found between the two groups in terms of complication rates, operative times and length of hospital stay. However, CUSUM chart analysis showed decreased operating times in the TRN group. Operative times improved more quickly for advanced cases. The results of this study indicate that LA can be performed by trainees without detrimental effects on clinical outcomes, procedural safety, and operative times. However, the learning curve is longer than previously acknowledged.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Laparoscopic appendectomy
- Trainees
- Surgical Training
- Learning curve
- Clinical outcomes
- CUSUM analysis
- resident involvement
- operative experience
- physical status
- impact
- participation
- cohort
- safe
- time
- complications
- trends
- Surgery
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Ussia, A.
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Vaccari, S.
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Gallo, G.
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Grossi, U.
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Ussia, R.
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Sartarelli, L.
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show more...
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Minghetti, M.
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Lauro, A.
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Barbieri, Paolo ...
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Di Saverio, S.
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Cervellera, M.
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Tonini, V.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Gastroenterology ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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Updates in Surge ...
- By the university
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University of Gothenburg