Resident Involvement in Radical Inguinal Orchiectomy for Testicular Cancer Does Not Adversely Impact Perioperative Outcomes - A Retrospective Study

TY - JOUR

T1 - Resident Involvement in Radical Inguinal Orchiectomy for Testicular Cancer Does Not Adversely Impact Perioperative Outcomes - A Retrospective Study

AU - Vetterlein, Malte W

AU - Seisen, Thomas

AU - Löppenberg, Björn

AU - Hanna, Nawar

AU - Cheng, Philip J

AU - Fisch, Margit

AU - Chun, Felix K-H

AU - Kibel, Adam S

AU - Preston, Mark A

AU - Meyer, Christian P

N1 - © 2016 S. Karger AG, Basel.

PY - 2017

Y1 - 2017

N2 - INTRODUCTION: To evaluate perioperative outcomes related to resident involvement (RI) in a large and prospectively collected multi-institutional database of patients undergoing orchiectomy for testicular cancer.MATERIALS AND METHODS: Using current procedural terminology and ICD-9 codes, information about patients with testicular cancer were abstracted from the American College of Surgeons National Surgical Quality Improvement Program database (2006-2013). Multivariable analyses evaluated the impact of RI on outcomes after orchiectomy. Prolonged operative time (pOT) and prolonged length of stay were defined by the 75th percentile (59 min) and postoperative inpatient stay ≥2 days, respectively.RESULTS: Overall, 267 patients underwent orchiectomy either with (38.6%) or without (61.4%) RI. In all, 89.1% of patients underwent an outpatient procedure. The median body mass index was 26.8 and baseline characteristics between the 2 groups were similar. Overall complications, re-intervention, and bleeding-related complication rates were 2.6, 0.7, and 0.4%, respectively. Although there was no difference in terms of overall complications between the groups (3.9 vs. 1.8%; p = 0.44), RI resulted in pOT (32 vs. 19.5%; p = 0.028). In multivariable analyses, RI predicted pOT (OR 1.89, 95% CI 1.06-3.37; p = 0.031), without association with prolonged length of stay and overall complications.CONCLUSIONS: RI during orchiectomy for testicular cancer does not undermine patient safety at the cost of pOT.

AB - INTRODUCTION: To evaluate perioperative outcomes related to resident involvement (RI) in a large and prospectively collected multi-institutional database of patients undergoing orchiectomy for testicular cancer.MATERIALS AND METHODS: Using current procedural terminology and ICD-9 codes, information about patients with testicular cancer were abstracted from the American College of Surgeons National Surgical Quality Improvement Program database (2006-2013). Multivariable analyses evaluated the impact of RI on outcomes after orchiectomy. Prolonged operative time (pOT) and prolonged length of stay were defined by the 75th percentile (59 min) and postoperative inpatient stay ≥2 days, respectively.RESULTS: Overall, 267 patients underwent orchiectomy either with (38.6%) or without (61.4%) RI. In all, 89.1% of patients underwent an outpatient procedure. The median body mass index was 26.8 and baseline characteristics between the 2 groups were similar. Overall complications, re-intervention, and bleeding-related complication rates were 2.6, 0.7, and 0.4%, respectively. Although there was no difference in terms of overall complications between the groups (3.9 vs. 1.8%; p = 0.44), RI resulted in pOT (32 vs. 19.5%; p = 0.028). In multivariable analyses, RI predicted pOT (OR 1.89, 95% CI 1.06-3.37; p = 0.031), without association with prolonged length of stay and overall complications.CONCLUSIONS: RI during orchiectomy for testicular cancer does not undermine patient safety at the cost of pOT.

U2 - 10.1159/000448596

DO - 10.1159/000448596

M3 - SCORING: Journal article

C2 - 27577733

VL - 98

SP - 472

EP - 477

JO - UROL INT

JF - UROL INT

SN - 0042-1138

IS - 4

ER -