24 Apr Study Compares Appendectomy Outcomes Between General Surgeons and Surgical Residents
MedicalResearch.com Interview with:
Haggi Mazeh, MD, FACS
Endocrine and General Surgery
Department of Surgery
Hadassah-Hebrew University Medical Center, Mount Scopus
Jerusalem, Israel 91240
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The level of operating room autonomy given to surgical residents varies greatly between different institutions and different countries. On one hand, providing residents the opportunity to operate alone augments their confidence and their sense of responsibility, possibly accelerating their learning process. On the other hand, it may be argued that the presence of a senior general surgeon in every operation is a safer approach.
Before 2012, a large proportion of appendectomies at our institution were performed by surgical residents alone. After 2012, our institutional policy changed to require the presence of a senior general surgeon in every appendectomy case. This unique situation provided us the opportunity to compare the outcomes of appendectomies performed by residents alone to those performed in the presence of a senior general surgeon.
Our study demonstrated no difference in the complication rates between the two groups of patients. However, surgeries performed in the presence of senior general surgeons were significantly shorter than those performed by residents.
MedicalResearch.com: What should readers take away from your report?
Response: I t seems that surgical residents, after a certain level of training, can safely perform appendectomy cases without the supervision of a senior general surgeon. Due to its relative simplicity, it seems that the appendectomy can be considered a model operation for the development of resident autonomy, at least within the confines of a structured academic residency program, without the compromise of standard of care.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: It is clear that the retrospective nature of our study comes with several limitations, and that prospective randomized trials would be required to verify the safety of residents performing appendectomy operations without supervision. We believe that in a controlled academic setting, such studies may be feasible.
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Siam B, Al-Kurd A, Simanovsky N, Awesat H, Cohn Y, Helou B, Eid A, Mazeh H. Comparison of Appendectomy Outcomes Between Senior General Surgeons and General Surgery Residents. JAMA Surg. Published online April 19, 2017. doi:10.1001/jamasurg.2017.0578
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