Surgical teaching does not increase the risk of intraoperative adverse events.

Details

Serval ID
serval:BIB_FFD05DC1898E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Surgical teaching does not increase the risk of intraoperative adverse events.
Journal
International journal of colorectal disease
Author(s)
Pache B., Grass F., Fournier N., Hübner M., Demartines N., Hahnloser D.
ISSN
1432-1262 (Electronic)
ISSN-L
0179-1958
Publication state
Published
Issued date
12/2018
Peer-reviewed
Oui
Volume
33
Number
12
Pages
1715-1722
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Training and teaching are cornerstones in developing surgical skills. The present study aimed to compare intraoperative outcomes of colonic resections among fellows, consultants, and supervised trainees.
Data of consecutive colonic resections including demographics, surgical details, and intraoperative outcomes were recorded in a prospectively maintained institutional database. All procedures were standardized and divided in three groups according to the main surgeons experience (fellow or consultant) and whether the procedure was taught. After weighting by inverse treatment probability, intraoperative adverse events including reactive conversion, blood loss, and operating time were compared between these three groups.
Six hundred sixty-four colectomies were analyzed between January 2014 and October 2017. Among them, 289 (43.5%) were taught. After weighted propensity score analysis, there was no difference between the three groups (fellow taken as reference), for intraoperative adverse event rate (odd ratio (OR) consultant 1.448 (IQR 0.728-2.878), p = 0.282; OR teaching 0.689 (IQR 0.295-1.609), p = 0.381), operating time (beta coefficient 0.76 (- 21.91-23.42), p = 0.947; beta coefficient - 10.79 (- 28.34-6.75), p = 0.919), conversion rates (OR 0.748 (0.329-1.515), p = 0.412; OR 1.025 (0.537-1.954), p = 0.940), pre-emptive conversion (OR 1.994 (0.198-20.032), p = 0.552; OR 0.659 (0.145-2.991), p = 0.583), intraoperative blood loss (beta coefficient 21.19 (- 25.87-68.25), p = 0.368; beta coefficient - 12.34 (- 56.13-31.44), p = 0.573), intraoperative transfusion (OR 1.962 (0.813-4.735), p = 0.127; OR 0.670 (0.260-1.727), p = 0.397), and rates of unusual bleeding (OR 1.273 (0.698-2.321), p = 0.422; OR 0.572 (0.290-1.126), p = 0.099). Time to preemptive conversion was shorter when procedures were performed by consultants (beta coefficient - 25.51 (- 47.71 to - 3.31), p = 0.025), while no difference was found for the teaching group (beta coefficient 4.48 (- 30.95-40.62), p = 0.788).
Within a standardized teaching environment, colonic resections were safely performed regardless of the surgical setting in the present cohort. Teaching does not increase intraoperative adverse events.
Keywords
Aged, Blood Loss, Surgical, Colectomy/education, Female, Humans, Intraoperative Complications/etiology, Male, Operative Time, Risk Factors, Time Factors, Adverse event, Complications, Outcomes, Surgery, Teaching
Pubmed
Web of science
Create date
03/09/2018 15:44
Last modification date
20/08/2019 17:30
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