The impact of resident involvement on tonsillectomy outcomes and surgical time

AbstractObjectiveThis study aimed to examine the impact of trainee involvement in performing tympanoplasty or tympano-ossiculoplasty on outcomes.MethodsA retrospective analysis was performed of a prospective database of all patients undergoing tympanoplasty and tympano-ossiculoplasty in a single centre during a three-year period. Patients were divided into three primary surgeon groups: consultants, fellows and residents. The outcomes of operative time, surgical complications, length of hospital stay, and air–bone gap improvement were compared among the groups.ResultsThe study included 398 tympanoplasty and tympano-ossiculoplasty surgical procedures, 71 per cent of which were performed by junior trainees (residents). The junior trainee group was associated with a significantly longer surgical time, without adverse impact on outcomes.ConclusionTrainee participation in tympanoplasty and tympano-ossiculoplasty surgery was associated with longer surgical time, but did not negatively affect the peri-operative course or hearing outcome. Therefore, resident involvement in these types of surgery is safe.

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The Learning Curve in Arthroscopic ACL Reconstruction. The impact on the Surgical Time and Postoperative Clinical Results

Revista de Chimie ◽

10.37358/rc.18.10.6643 ◽

2018 ◽

Vol 69 (10) ◽

pp. 2874-2876

Author(s):

Teodor Negru ◽

Stefan Mogos ◽

Ioan Cristian Stoica

Keyword(s):

Anterior Cruciate Ligament ◽

Learning Curve ◽

Clinical Outcomes ◽

Positive Impact ◽

Cruciate Ligament ◽

Clinical Results ◽

Single Bundle ◽

Surgical Time ◽

Anterior Cruciate ◽

The Impact

Rupture of the anterior cruciate ligament (ACL) is a common injury. The objective of the current study was to evaluate if the learning curve has an impact on surgical time and postoperative clinical outcomes after anatomic single-bundle anterior cruciate ligament reconstruction (ACLR) using an outside-in tunnel drilling hamstrings technique. The learning curve has a positive impact on surgical time but has no influence on postoperative clinical outcomes at short time follow-up.

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The impact of resident involvement on otolaryngology surgical outcomes

The Laryngoscope ◽

10.1002/lary.25046 ◽

2015 ◽

Vol 126 (3) ◽

pp. 602-607 ◽

Cited By ~ 14

Author(s):

Brittany L. Vieira ◽

David J. Hernandez ◽

Charles Qin ◽

Stephanie S. Smith ◽

John Y. S. Kim ◽

...

Keyword(s):

Surgical Outcomes ◽

Resident Involvement ◽

The Impact

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1065 The impact of resident involvement in 1-stage urethroplasties

European Urology Supplements ◽

10.1016/s1569-9056(15)61053-3 ◽

2015 ◽

Vol 14 (2) ◽

pp. e1065

Author(s):

C.P. Meyer ◽

J. Hanske ◽

M. Schmid ◽

D. Friedlander ◽

J.R. Eswara ◽

...

Keyword(s):

Resident Involvement ◽

The Impact

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Arthroscopic ankle fusion only has a limited advantage over the open operation if osseous operation type is the same: a retrospective comparative study

10.21203/rs.2.22987/v1 ◽

2020 ◽

Author(s):

Chenggong Wang ◽

Can Xu ◽

Mingqing Li ◽

Hui Li ◽

Long Wang ◽

...

Keyword(s):

Blood Loss ◽

Selection Bias ◽

Functional Score ◽

Surgical Trauma ◽

Surgical Time ◽

Postoperative Function ◽

Ankle Fusion ◽

Open Operation ◽

Hospital Stays ◽

The Impact

Abstract Background: A great deal of research suggests that arthroscopic ankle fusion (AAF) has advantages over open ankle fusion (OAF), but these outcomes would be imprecise because of a selection bias. The purpose of this study is to verify which is better for ankle fusion, AAF or OAF. We regrouped the OAF group into two subgroups according to whether the osseous operation type is the same as AAF group. The goal is to minimize the impact of disease severity, thereby reducing selection bias to some extent.Methods: We retrospectively analyzed the data of ankle fusion in our hospital between July 2015 and October 2018. 43 patients were enrolled and divided into AAF group (n=17) and OAF group (n=26). In order to eliminate selection bias, we divided OAF group into complex osseous operation subgroup (COO subgroup) (n=15) and simple osseous operation subgroup (SOO subgroup) (n=11). The osseous operation type of SOO subgroup is the same as AAF group. Then, we compared the differences between these groups. All patients were followed up at least one year after operation. We analyzed data, including etiology composition, surgical time, intra-op blood loss, reduction of albumin, total hospital stays, union time, fusion situation, complications, radiological examination, functional score and questionnaire survey. Then we performed statistical analyses.Results: We found that the etiological components of AAF group and OAF group were different; the etiological components of AAF group and SOO subgroup were similar. We found that AAF group has advantages over OAF group and COO subgroup in general. However, except in terms of surgical trauma, hospital stays and short-term complications occurred, the AAF group has not obvious advantages over SOO subgroup, including intra-op blood loss, fusion condition, postoperative function score and postoperative patient satisfaction; and AAF group need more surgical time than the SOO subgroup.Conclusions: The arthroscopic ankle fusion can bring a good curative effect; however, if the osseous operation type is the same, the arthroscopic ankle fusion only has a limited advantage over the traditional open operation in perioperative soft tissue protection and enhanced recovery after surgery.

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Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery

10.21203/rs.3.rs-893239/v1 ◽

2021 ◽

Author(s):

Meritxell Gracia ◽

Cristian de Guirior ◽

Marta Valdés-Bango ◽

Mariona Rius ◽

Cristina Ros ◽

...

Keyword(s):

Multivariate Analysis ◽

Risk Factor ◽

Laparoscopic Surgery ◽

Surgical Complications ◽

Transvaginal Ultrasound ◽

Surgical Time ◽

Deep Endometriosis ◽

Analysis Group ◽

Increased Risk ◽

The Impact

Abstract Background Deep endometriosis (DE) occurs in 15–30% of patients with endometriosis and is associated with concomitant adenomyosis in around 49% of cases. There are no data about the effect of the presence of adenomyosis in terms of surgical outcomes and complications. Thus, the aim of the present study was to evaluate the impact of adenomyosis on surgical complications in women with deep endometriosis undergoing laparoscopic surgery. Methods A retrospective cohort study including women referred to the endometriosis unit of a referral teaching hospital. Two expert sonographers preoperatively diagnosed DE and adenomyosis. DE was defined according to the criteria of the International Deep Endometriosis Analysis group. Adenomyosis was considered when 3 or more ultrasound criteria of the Morphological Uterus Sonographic Assessment group were present. Demographical variables, current medical treatment, symptoms, DE location, surgical time, hospital stay and difference in pre and post hemoglobin levels were collected. The Clavien-Dindo classification was used to assess surgical complications, and multivariate analysis was performed to compare patients with and without adenomyosis. Results 157 DE patients were included into the study; 77 (49.05%) had adenomyosis according to transvaginal ultrasound (TVS) and were classified in the A group, and 80 (50.95%) had no adenomyosis and were classified in the noA group. Adenomyosis was associated with a higher rate of surgical complications: 33.76% (A group) vs. 12.5% (noA group) (p < 0.001). Multivariate analysis showed a 4.56-fold increased risk of presenting complications in women with adenomyosis (CI: 1.9–11.3; p = 0.001) independently of undergoing hysterectomy. There was a statistically significant association between the number of criteria of adenomyosis present in each patient and the proportion of patients presenting surgical complications (p < 0.001). Conclusions Adenomyosis increases the risk of presenting complications in DE surgery after controlling for demographic, clinical and surgical factors and should be considered an independent preoperative risk factor of surgical complications.

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Impact of Video Describing Cataract Surgical Simulator Training on Patients' Perceptions of Resident Involvement in Cataract Surgery

Journal of Academic Ophthalmology ◽

10.1055/s-0041-1728659 ◽

2021 ◽

Vol 13 (02) ◽

pp. e96-e101

Author(s):

Zachary C. Landis ◽

John B. Fileta ◽

Allen R. Kunselman ◽

Joseph Sassani ◽

Ingrid U. Scott

Keyword(s):

Cataract Surgery ◽

Medical Training ◽

Resident Training ◽

Simulator Training ◽

Surgical Simulator ◽

Resident Involvement ◽

Group 2 ◽

The Impact ◽

Group 1 ◽

Patient Willingness

Abstract Purpose The aim of this article is to investigate the impact of a 1-minute video describing resident training with a cataract surgical simulator on patients' perceptions regarding resident involvement in cataract surgery and to identify factors associated with patient willingness to have cataract surgery performed by a resident. Design Cross-sectional survey. Methods An anonymous Likert-style survey was conducted among 430 consecutive adult patients who presented for eye examination at the Penn State Health Eye Center. The survey included questions regarding demographics, understanding of the medical training hierarchy, and patient willingness to have a resident perform their cataract surgery. There were six questions regarding patient willingness to have residents perform their cataract surgery and the second question in this set informs the patient that residents are supervised by an experienced cataract surgeon. Patients were randomly assigned to one of two groups: patients in Group 1 completed the survey only, while patients in Group 2 watched a 1-minute video describing resident training with a cataract surgical simulator prior to completing the survey. Results Four hundred fourteen of the 430 patients (96.3%) completed the survey. Overall, 24.7% (n = 102) of respondents expressed willingness to allow an ophthalmology resident to perform their cataract surgery, and that proportion increased to 54.0% (n = 223) if the patient was informed that the resident would be supervised by an experienced cataract surgeon. Patients in Group 2 were twice as likely compared with patients in Group 1 to express willingness to allow an ophthalmology resident to perform their cataract surgery (odds ratio 1.92 [1.18–3.11], p = 0.009). Conclusions A thorough informed consent process including information regarding attending supervision and a brief video detailing resident training with a cataract surgery simulator may increase patient willingness to allow resident participation in cataract surgery.

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The impact of resident involvement in minimally-invasive urologic oncology procedures

Canadian Urological Association Journal ◽

10.5489/cuaj.2170 ◽

2014 ◽

Vol 8 (9-10) ◽

pp. 334 ◽

Cited By ~ 37

Author(s):

Nedim Ruhotina ◽

Julien Dagenais ◽

Giorgio Gandaglia ◽

Akshay Sood ◽

Firas Abdollah ◽

...

Keyword(s):

Length Of Stay ◽

Minimally Invasive ◽

Partial Nephrectomy ◽

Operative Time ◽

Readmission Rates ◽

Improvement Program ◽

Urologic Oncology ◽

Invasive Approach ◽

Resident Involvement ◽

The Impact

Introduction: Robotic and laparoscopic surgical training is an integral part of resident education in urology, yet the effect of resident involvement on outcomes of minimally-invasive urologic procedures remains largely unknown. We assess the impact of resident participation on surgical outcomes using a large multi-institutional prospective database.Methods: Relying on the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Participant User Files (2005-2011), we abstracted the 3 most frequently performed minimally-invasive urologic oncology procedures. These included radical prostatectomy, radical nephrectomy and partial nephrectomy. Multivariable logistic regression models were constructed to assess the impact of trainee involvement (PGY 1-2: junior, PGY 3-4: senior, PGY ≥5: chief) versus attending-only on operative time, length-of-stay, 30-day complication, reoperation and readmission rates.Results: A total of 5459 minimally-invasive radical prostatectomies,1740 minimally-invasive radical nephrectomies and 786 minimally-invasive partial nephrectomies were performed during the study period, for which data on resident surgeon involvement was available. In multivariable analyses, resident involvement was not associated with increased odds of overall complications, reoperation, or readmission rates for minimally-invasive prostatectomy, radical and partial nephrectomy. However, operative time was prolonged when residents were involved irrespective of the type of procedure. Length-of-stay was decreased with senior resident involvement in minimally-invasive partial nephrectomies (odds ratio [OR] 0.49, p = 0.04) and prostatectomies (OR 0.68, p = 0.01). The major limitations of this study include its retrospective observational design, inability to adjust for the case complexity and surgeon/hospital characteristics, and the lack of information regarding the minimally-invasive approach utilized (whether robotic or laparoscopic).Conclusions: Resident involvement is associated with increased operative time in minimally-invasive urologic oncology procedures. However, it does not adversely affect the complication, reoperation or readmission rates, as well as length-of-stay.

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