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Comparative Study
. 2017 Jul 1;152(7):679-685.
doi: 10.1001/jamasurg.2017.0578.

Comparison of Appendectomy Outcomes Between Senior General Surgeons and General Surgery Residents

Baha Siam  1 , Abbas Al-Kurd  1 , Natalia Simanovsky  2 , Haitham Awesat  1 , Yahav Cohn  1 , Brigitte Helou  1 , Ahmed Eid  1 , Haggi Mazeh  1
Affiliations
Comparative Study

Comparison of Appendectomy Outcomes Between Senior General Surgeons and General Surgery Residents

Baha Siam et al. JAMA Surg. .

Abstract

Importance: In some centers, the presence of a senior general surgeon (SGS) is obligatory in every procedure, including appendectomy, while in others it is not. There is a relative paucity in the literature of reports comparing the outcomes of appendectomies performed by unsupervised general surgery residents (GSRs) with those performed in the presence of an SGS.

Objective: To compare the outcomes of appendectomies performed by SGSs with those performed by GSRs.

Design, setting, and participants: A retrospective analysis was performed of all patients 16 years or older operated on for assumed acute appendicitis between January 1, 2008, and December 31, 2015. The cohort study compared appendectomies performed by SGSs and GSRs in the general surgical department of a teaching hospital.

Main outcomes and measures: The primary outcome measured was the postoperative early and late complication rates. Secondary outcomes included time from emergency department to operating room, length of surgery, surgical technique (open or laparoscopic), use of laparoscopic staplers, and overall duration of postoperative antibiotic treatment.

Results: Among 1649 appendectomy procedures (mean [SD] patient age, 33.7 [13.3] years; 612 female [37.1%]), 1101 were performed by SGSs and 548 by GSRs. Analysis demonstrated no significant difference between the SGS group and the GSR group in overall postoperative early and late complication rates, the use of imaging techniques, time from emergency department to operating room, percentage of complicated appendicitis, postoperative length of hospital stay, and overall duration of postoperative antibiotic treatment. However, length of surgery was significantly shorter in the SGS group than in the GSR group (mean [SD], 39.9 [20.9] vs 48.6 [20.2] minutes; P < .001).

Conclusions and relevance: This study demonstrates that unsupervised surgical residents may safely perform appendectomies, with no difference in postoperative early and late complication rates compared with those performed in the presence of an SGS.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure.
Figure.. Study Flowchart
GSR indicates general surgery resident; SGS, senior general surgeon.
See this image and copyright information in PMC

Comment in

References

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