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International Journal of Colorectal Disease

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01-12-2018 | Original Article

Surgical teaching does not increase the risk of intraoperative adverse events

Authors: Basile Pache, Fabian Grass, Nicolas Fournier, Martin Hübner, Nicolas Demartines, Dieter Hahnloser

Published in: International Journal of Colorectal Disease | Issue 12/2018

Abstract

Introduction

Training and teaching are cornerstones in developing surgical skills. The present study aimed to compare intraoperative outcomes of colonic resections among fellows, consultants, and supervised trainees.

Methods

Data of consecutive colonic resections including demographics, surgical details, and intraoperative outcomes were recorded in a prospectively maintained institutional database. All procedures were standardized and divided in three groups according to the main surgeons experience (fellow or consultant) and whether the procedure was taught. After weighting by inverse treatment probability, intraoperative adverse events including reactive conversion, blood loss, and operating time were compared between these three groups.

Results

Six hundred sixty-four colectomies were analyzed between January 2014 and October 2017. Among them, 289 (43.5%) were taught. After weighted propensity score analysis, there was no difference between the three groups (fellow taken as reference), for intraoperative adverse event rate (odd ratio (OR) consultant 1.448 (IQR 0.728–2.878), p = 0.282; OR teaching 0.689 (IQR 0.295–1.609), p = 0.381), operating time (beta coefficient 0.76 (− 21.91–23.42), p = 0.947; beta coefficient − 10.79 (− 28.34–6.75), p = 0.919), conversion rates (OR 0.748 (0.329–1.515), p = 0.412; OR 1.025 (0.537–1.954), p = 0.940), pre-emptive conversion (OR 1.994 (0.198–20.032), p = 0.552; OR 0.659 (0.145–2.991), p = 0.583), intraoperative blood loss (beta coefficient 21.19 (− 25.87–68.25), p = 0.368; beta coefficient − 12.34 (− 56.13–31.44), p = 0.573), intraoperative transfusion (OR 1.962 (0.813–4.735), p = 0.127; OR 0.670 (0.260–1.727), p = 0.397), and rates of unusual bleeding (OR 1.273 (0.698–2.321), p = 0.422; OR 0.572 (0.290–1.126), p = 0.099). Time to preemptive conversion was shorter when procedures were performed by consultants (beta coefficient − 25.51 (− 47.71 to − 3.31), p = 0.025), while no difference was found for the teaching group (beta coefficient 4.48 (− 30.95–40.62), p = 0.788).

Conclusion

Within a standardized teaching environment, colonic resections were safely performed regardless of the surgical setting in the present cohort. Teaching does not increase intraoperative adverse events.

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Title: Surgical teaching does not increase the risk of intraoperative adverse events
Authors: Basile Pache
Fabian Grass
Nicolas Fournier
Martin Hübner
Nicolas Demartines
Dieter Hahnloser
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 12/2018
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-018-3143-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Surgical teaching does not increase the risk of intraoperative adverse events

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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