The Effect of Resident Involvement on Perioperative Outcomes in Transurethral Urologic Surgeries

TY - JOUR

T1 - The Effect of Resident Involvement on Perioperative Outcomes in Transurethral Urologic Surgeries

AU - Allard, Christopher B

AU - Meyer, Christian P

AU - Gandaglia, Giorgio

AU - Chang, Steven L

AU - Chun, Felix K H

AU - Gelpi-Hammerschmidt, Francisco

AU - Hanske, Julian

AU - Kibel, Adam S

AU - Preston, Mark A

AU - Trinh, Quoc-Dien

N1 - Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

PY - 2015/5/25

Y1 - 2015/5/25

N2 - OBJECTIVE: To conduct the first study of intra- and postoperative outcomes related to intraoperative resident involvement in transurethral resection procedures for benign prostatic hyperplasia and bladder cancer in a large, multi-institutional database.DESIGN: Relying on the American College of Surgeons National Surgical Quality Improvement Program Participant User Files (2005-2012), we abstracted all cases of endoscopic prostate surgery (EPS) for benign prostatic hyperplasia and transurethral resection of bladder tumors (TURBTs). Multivariable logistic regression models were constructed to assess the effect of trainee involvement (postgraduate year [PGY] 1-2: junior, PGY 3-4: senior, PGY ≥ 5: chief or fellow) vs attending only on operative time and length of hospital stay, as well as 30-day complication, reoperation, and readmission rates.RESULTS: In all, 5093 EPS and 3059 TURBTs for a total of 8152 transurethral resection procedures were performed during the study period for which data on resident involvement were available. In multivariable analyses, resident involvement in EPS or TURBT was associated with increased odds of prolonged operative times and hospital readmissions in 30 days independent of resident level of training. Resident involvement was not associated with overall complications or reoperation rates.CONCLUSIONS: Resident involvement in lower urinary tract surgeries is associated with increased readmissions. Strategies to optimize resident teaching of these common urologic procedures in order to minimize possible risks to patients should be explored.

AB - OBJECTIVE: To conduct the first study of intra- and postoperative outcomes related to intraoperative resident involvement in transurethral resection procedures for benign prostatic hyperplasia and bladder cancer in a large, multi-institutional database.DESIGN: Relying on the American College of Surgeons National Surgical Quality Improvement Program Participant User Files (2005-2012), we abstracted all cases of endoscopic prostate surgery (EPS) for benign prostatic hyperplasia and transurethral resection of bladder tumors (TURBTs). Multivariable logistic regression models were constructed to assess the effect of trainee involvement (postgraduate year [PGY] 1-2: junior, PGY 3-4: senior, PGY ≥ 5: chief or fellow) vs attending only on operative time and length of hospital stay, as well as 30-day complication, reoperation, and readmission rates.RESULTS: In all, 5093 EPS and 3059 TURBTs for a total of 8152 transurethral resection procedures were performed during the study period for which data on resident involvement were available. In multivariable analyses, resident involvement in EPS or TURBT was associated with increased odds of prolonged operative times and hospital readmissions in 30 days independent of resident level of training. Resident involvement was not associated with overall complications or reoperation rates.CONCLUSIONS: Resident involvement in lower urinary tract surgeries is associated with increased readmissions. Strategies to optimize resident teaching of these common urologic procedures in order to minimize possible risks to patients should be explored.

U2 - 10.1016/j.jsurg.2015.04.012

DO - 10.1016/j.jsurg.2015.04.012

M3 - SCORING: Journal article

C2 - 26003818

VL - 72

SP - 1018

EP - 1025

JO - J SURG EDUC

JF - J SURG EDUC

SN - 1931-7204

IS - 5

ER -