Safety assessment of open appendectomies for complicated acute appendicitis in children: a comparison of trainees and sp
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ORIGINAL ARTICLE
Safety assessment of open appendectomies for complicated acute appendicitis in children: a comparison of trainees and specialists George Vaos1 · Nick Zavras1 · Anastasia Dimopoulou1 · Emmanouil Iakomidis1 · George Pantalos2 · Alexander Passalides2 Accepted: 6 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The aim of this study was to compare the outcome of children with complicated acute appendicitis (CAA) who underwent open appendectomy (OA) performed either by trainees under the direct supervision of an SPS, or an SPS. Methods Two hundred thirty eight patients with CAA were reviewed operated on either by a junior trainee (JT) or a senior trainee (ST) under the direct supervision of an SPS or by an SPS. The outcome measures were the overall rate of complications, operative time (OT), length of hospital stay (LHS) and 30-day readmission rate. Results No statistical differences were observed between the three groups regarding the overall complication rates and 30-day readmission rate. Although, no statistical differences were observed in the mean OT between the three groups, the mean OT for perforated appendicitis (PA) performed by JTs was significantly longer than when performed by SPSs (p 0.012). Furthermore, there was a statistically significant difference between JTs and SPSs in terms of LHS for patients with PA (p 0.028). Conclusion This study suggests that no statistical differences were observed between the supervised trainees and SPSs regarding the overall complication rate and 30-readmission rate when they performed OA for GA or PA except of a longer OT and LHS for PA performed by JTs. Keywords Appendectomy · Complicated acute appendicitis · Children · Trainee · Outcomes
Introduction Surgical training requires that trainees have the opportunity to operate without compromising the patients’ safety. In general, it is important to know whether care provided by trainees is of equal quality to that provided by specialists [1]. The assessment of operative performance and trainees’ readiness to perform operations independently is still challenging [2]. Very recently, the System for Improving and Measuring Procedural Learning (SIMPL) has been implemented in a pediatric surgery training program to allow case by case operative performance assessment of trainees. * George Vaos [email protected] 1
Department of Pediatric Surgery, “ATTIKON” University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Second Department of Pediatric Surgery, P & A Kyriakou Children’s Hospital, Thivon & Levadias Str, 11527 Athens, Greece
2
SIMPL increased the volume of operative assessments and showed progressive performance improvement over time [3]. Although there is no consensus regarding the ideal operation to gain experience in pediatric surgery, appendectomy, either open or laparoscopically, is a routine surgical procedure performed early by trainees during their educational course in the field of pediatric su
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