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The Impact of Trainee Involvement on Outcomes in Metabolic and Bariatric Surgery.
Hoagland, Darian; Olasky, Jaisa; Kent, Tara S; Vosburg, R Wesley.
Afiliação
  • Hoagland D; Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA.
  • Olasky J; Department of Surgery, Lenox Hill Hospital, New York, USA.
  • Kent TS; Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA.
  • Vosburg RW; Department of surgery Mount Auburn Hospital, Harvard Medical School, 355 Waverley Oaks rd, suite 100, Waltham, MA, 02452, USA. rvosburg@mah.harvard.edu.
Obes Surg ; 33(11): 3454-3462, 2023 11.
Article em En | MEDLINE | ID: mdl-37755646
ABSTRACT

BACKGROUND:

The number of bariatric operations performed in the USA rises annually. Trainee exposure to this field is necessary to ensure competency in future surgical generations. However, the safety of trainee involvement of these operations has been called into question.

OBJECTIVES:

The aim of our study is to describe differences in outcomes between trainees and non-trainees as first assistants (FA) in sleeve gastrectomy (SG).

SETTING:

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database

METHODS:

Patients from the MBSAQIP database who underwent primary SG from 2015 to 2020 were identified. Statistical analysis included two-tailed t-tests and χ2-tests to evaluate the impact of trainees (residents and fellows) compared to non-trainees on post-operative morbidity and operative time.

RESULTS:

Of the 559,324 cases, 25.8% were performed with trainees as FA. Operative length was 27.9% longer in trainee cases. In the trainee group, there was a higher risk of conversion to open procedure (OR 1.32), readmission (OR 1.19), and specific complications (cardiac arrest, myocardial infarction, progressive renal insufficiency, pulmonary embolism, sepsis, transfusion, intubation, UTI, VTE, ICU admission, and reintervention), though overall rates were < 1% in each group. Non-trainees had a higher rate of septic shock (OR 1.4). No significant difference was seen in all other perioperative outcomes.

CONCLUSION:

Trainee involvement in SG leads to longer operative times without a clinically significant increase in morbidity and mortality. Such findings should be used to counsel patients and shape expectations for surgeons and hospitals. A focused bariatric surgery trainee curriculum may lessen this gap.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Obesidade Mórbida / Derivação Gástrica / Cirurgia Bariátrica / Cirurgiões Tipo de estudo: Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Obesidade Mórbida / Derivação Gástrica / Cirurgia Bariátrica / Cirurgiões Tipo de estudo: Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article