Comparing results of residents and attending surgeons to determine whether laparoscopic colectomy is safe

被引:28
作者
Mehall, JR
Shroff, S
Fassler, SA
Harper, SG
Nejman, JH
Zebley, DM
机构
[1] Abington Mem Hosp, Dept Surg, Abington, PA 19001 USA
[2] Holy Redeemer Hosp, Dept Surg, Meadowbrook, PA USA
关键词
laparoscopy; colon resection; resident education; patient safety;
D O I
10.1016/j.amjsurg.2005.03.018
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: This study was undertaken to compare the technical success and outcomes of laparoscopic colectomy performed by resident surgeons (RS) and attending surgeons (AS). Methods: A review of 451 consecutive laparoscopic colectomies per-formed by 2 surgeons either with or without a general surgery resident. Data reviewed included demographics, diagnoses, operative data, and outcomes. Comparison was made between patients operated on by RS under attending surgeon supervision, and patients operated on by AS alone. Results: Of 451 patients, 324 were operated on by RS and 127 by AS. The mean age and preoperative diagnoses were similar between groups. Operative time was significantly longer in the RS group (155 minutes vs. 128 minutes, P <.05). Blood loss was slightly higher in RS groups but was not statistically significant (191 mL vs. 174 mL, P =.31). The incidence of conversion to an open procedure, postoperative complications, and length of stay were similar between groups. Conclusions: Supervised RS can safely perform laparoscopic colectomy with results similar to AS. RS take longer to perform the procedure than AS. (c) 2005 Excerpta Medica Inc. All rights reserved.
引用
收藏
页码:738 / 741
页数:4
相关论文
共 8 条
[1]   Outcomes and resource utilization for patients with prolonged critical illness managed by university-based or community-based subspecialists [J].
Bach, PB ;
Carson, SS ;
Leff, A .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1998, 158 (05) :1410-1415
[2]   Is it safe to train residents to perform cardiac surgery? [J].
Baskett, RJF ;
Buth, KJ ;
Legaré, JF ;
Hassan, A ;
Friesen, CH ;
Hirsch, GM ;
Ross, DB ;
Sullivan, JA .
ANNALS OF THORACIC SURGERY, 2002, 74 (04) :1043-1048
[3]   Laparoscopic versus open colorectal surgery - A randomized trial on short-term outcome [J].
Braga, M ;
Vignali, A ;
Gianotti, L ;
Zuliani, W ;
Radaelli, G ;
Gruarin, P ;
Dellabona, P ;
Di Carlo, V .
ANNALS OF SURGERY, 2002, 236 (06) :759-766
[4]   The future of medical education is no longer blood and guts, it is bits and bytes [J].
Gorman, PJ ;
Meier, AH ;
Rawn, C ;
Krummel, TM .
AMERICAN JOURNAL OF SURGERY, 2000, 180 (05) :353-356
[5]   Laparoscopic vs. open resection for colorectal adenocarcinoma [J].
Hong, D ;
Tabet, J ;
Anvari, M .
DISEASES OF THE COLON & RECTUM, 2001, 44 (01) :10-18
[6]   Housestaff performance is improved by participation in a laparoscopic skills curriculum [J].
Powers, TW ;
Murayama, KM ;
Toyama, M ;
Murphy, S ;
Denham, EW ;
Derossis, AM ;
Joehl, RJ .
AMERICAN JOURNAL OF SURGERY, 2002, 184 (06) :626-629
[7]   Laparoscopically assisted colorectal surgery in the elderly [J].
Stewart, BT ;
Stitz, RW ;
Lumley, JW .
BRITISH JOURNAL OF SURGERY, 1999, 86 (07) :938-941
[8]   Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer - A randomized trial [J].
Weeks, JC ;
Nelson, H ;
Gelber, S ;
Sargent, D ;
Schroeder, G .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 287 (03) :321-328