Resident participation and postoperative outcomes in adrenal surgery

Raghunandan Venkat, Patricio L. Valdivia, Marlon A Guerrero

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background The changing paradigm of surgical residency training has raised concerns about the effects on the quality of training. The purpose of this study is to identify if resident participation in laparoscopic adrenalectomy (LA) and open adrenalectomy (OA) cases is associated with deleterious outcomes. Materials and methods This is a retrospective study using the American College of Surgeons National Surgical Quality Improvement Program database. Data from patients undergoing LA and OA from 2005 to 2010 were queried. Preoperative variables as well as intra- and post-operative outcomes for each procedure were evaluated. Multivariate logistic regression was used to analyze if resident participation was associated with significant differences in outcomes, compared with no resident participation. Subset analysis was done to determine possible differences in outcomes based on the level of resident participating, divided into junior (Post Graduate Year [PGY]1-3), senior (PGY4-5), or fellow (≥PGY6) levels. Results A total of 3219 adrenalectomies were performed. Of these, 735 (22.8%) were OAs and 2484 (77.2%) were LAs. Residents were involved in 2582 (80.2%) surgeries, which comprised 1985 (76.9%) LAs and 597 (23.1%) OAs. Senior residents or fellows performed majority of the cases (85.2%). Mean operative time was significantly higher with resident participation in LA (P < 0.0001) and OA group (P < 0.0001). On multivariate analysis, resident participation was not associated with significant differences in the operative outcomes of 30-d mortality or postoperative complications after laparoscopic or OA. Conclusions Although resident participation does increase operative time in LA and OA, this does not appear to be clinically significant and does not result in adverse patient outcomes.

Original languageEnglish (US)
Pages (from-to)559-564
Number of pages6
JournalJournal of Surgical Research
Volume190
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Adrenalectomy
Operative Time
Internship and Residency
Quality Improvement
Multivariate Analysis
Retrospective Studies
Logistic Models
Databases
Mortality

Keywords

  • Adrenalectomy
  • Endocrine surgery
  • Laparoscopic
  • NSQIP
  • Resident
  • Surgical outcomes

ASJC Scopus subject areas

  • Surgery

Cite this

Resident participation and postoperative outcomes in adrenal surgery. / Venkat, Raghunandan; Valdivia, Patricio L.; Guerrero, Marlon A.

In: Journal of Surgical Research, Vol. 190, No. 2, 2014, p. 559-564.

Research output: Contribution to journalArticle

Venkat, Raghunandan ; Valdivia, Patricio L. ; Guerrero, Marlon A. / Resident participation and postoperative outcomes in adrenal surgery. In: Journal of Surgical Research. 2014 ; Vol. 190, No. 2. pp. 559-564.
@article{202d385e7bb04cf981e5085d929ab0be,
title = "Resident participation and postoperative outcomes in adrenal surgery",
abstract = "Background The changing paradigm of surgical residency training has raised concerns about the effects on the quality of training. The purpose of this study is to identify if resident participation in laparoscopic adrenalectomy (LA) and open adrenalectomy (OA) cases is associated with deleterious outcomes. Materials and methods This is a retrospective study using the American College of Surgeons National Surgical Quality Improvement Program database. Data from patients undergoing LA and OA from 2005 to 2010 were queried. Preoperative variables as well as intra- and post-operative outcomes for each procedure were evaluated. Multivariate logistic regression was used to analyze if resident participation was associated with significant differences in outcomes, compared with no resident participation. Subset analysis was done to determine possible differences in outcomes based on the level of resident participating, divided into junior (Post Graduate Year [PGY]1-3), senior (PGY4-5), or fellow (≥PGY6) levels. Results A total of 3219 adrenalectomies were performed. Of these, 735 (22.8{\%}) were OAs and 2484 (77.2{\%}) were LAs. Residents were involved in 2582 (80.2{\%}) surgeries, which comprised 1985 (76.9{\%}) LAs and 597 (23.1{\%}) OAs. Senior residents or fellows performed majority of the cases (85.2{\%}). Mean operative time was significantly higher with resident participation in LA (P < 0.0001) and OA group (P < 0.0001). On multivariate analysis, resident participation was not associated with significant differences in the operative outcomes of 30-d mortality or postoperative complications after laparoscopic or OA. Conclusions Although resident participation does increase operative time in LA and OA, this does not appear to be clinically significant and does not result in adverse patient outcomes.",
keywords = "Adrenalectomy, Endocrine surgery, Laparoscopic, NSQIP, Resident, Surgical outcomes",
author = "Raghunandan Venkat and Valdivia, {Patricio L.} and Guerrero, {Marlon A}",
year = "2014",
doi = "10.1016/j.jss.2014.05.025",
language = "English (US)",
volume = "190",
pages = "559--564",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Resident participation and postoperative outcomes in adrenal surgery

AU - Venkat, Raghunandan

AU - Valdivia, Patricio L.

AU - Guerrero, Marlon A

PY - 2014

Y1 - 2014

N2 - Background The changing paradigm of surgical residency training has raised concerns about the effects on the quality of training. The purpose of this study is to identify if resident participation in laparoscopic adrenalectomy (LA) and open adrenalectomy (OA) cases is associated with deleterious outcomes. Materials and methods This is a retrospective study using the American College of Surgeons National Surgical Quality Improvement Program database. Data from patients undergoing LA and OA from 2005 to 2010 were queried. Preoperative variables as well as intra- and post-operative outcomes for each procedure were evaluated. Multivariate logistic regression was used to analyze if resident participation was associated with significant differences in outcomes, compared with no resident participation. Subset analysis was done to determine possible differences in outcomes based on the level of resident participating, divided into junior (Post Graduate Year [PGY]1-3), senior (PGY4-5), or fellow (≥PGY6) levels. Results A total of 3219 adrenalectomies were performed. Of these, 735 (22.8%) were OAs and 2484 (77.2%) were LAs. Residents were involved in 2582 (80.2%) surgeries, which comprised 1985 (76.9%) LAs and 597 (23.1%) OAs. Senior residents or fellows performed majority of the cases (85.2%). Mean operative time was significantly higher with resident participation in LA (P < 0.0001) and OA group (P < 0.0001). On multivariate analysis, resident participation was not associated with significant differences in the operative outcomes of 30-d mortality or postoperative complications after laparoscopic or OA. Conclusions Although resident participation does increase operative time in LA and OA, this does not appear to be clinically significant and does not result in adverse patient outcomes.

AB - Background The changing paradigm of surgical residency training has raised concerns about the effects on the quality of training. The purpose of this study is to identify if resident participation in laparoscopic adrenalectomy (LA) and open adrenalectomy (OA) cases is associated with deleterious outcomes. Materials and methods This is a retrospective study using the American College of Surgeons National Surgical Quality Improvement Program database. Data from patients undergoing LA and OA from 2005 to 2010 were queried. Preoperative variables as well as intra- and post-operative outcomes for each procedure were evaluated. Multivariate logistic regression was used to analyze if resident participation was associated with significant differences in outcomes, compared with no resident participation. Subset analysis was done to determine possible differences in outcomes based on the level of resident participating, divided into junior (Post Graduate Year [PGY]1-3), senior (PGY4-5), or fellow (≥PGY6) levels. Results A total of 3219 adrenalectomies were performed. Of these, 735 (22.8%) were OAs and 2484 (77.2%) were LAs. Residents were involved in 2582 (80.2%) surgeries, which comprised 1985 (76.9%) LAs and 597 (23.1%) OAs. Senior residents or fellows performed majority of the cases (85.2%). Mean operative time was significantly higher with resident participation in LA (P < 0.0001) and OA group (P < 0.0001). On multivariate analysis, resident participation was not associated with significant differences in the operative outcomes of 30-d mortality or postoperative complications after laparoscopic or OA. Conclusions Although resident participation does increase operative time in LA and OA, this does not appear to be clinically significant and does not result in adverse patient outcomes.

KW - Adrenalectomy

KW - Endocrine surgery

KW - Laparoscopic

KW - NSQIP

KW - Resident

KW - Surgical outcomes

UR - http://www.scopus.com/inward/record.url?scp=84904260398&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84904260398&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2014.05.025

DO - 10.1016/j.jss.2014.05.025

M3 - Article

C2 - 24950796

AN - SCOPUS:84904260398

VL - 190

SP - 559

EP - 564

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 2

ER -