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Systematic review and meta-analysis comparing perioperative outcomes of emergency appendectomy performed by trainee vs trained surgeon
Appendectomy is a benchmark operation for trainee progression, but this should be weighed against patient safety and perioperative outcomes. Systematic literature review and meta-analysis comparing outcomes of appendectomy performed by trainees versus trained surgeons. Of 2086 articles screened, 29...
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| Published in: | The American journal of surgery 2023-01, Vol.225 (1), p.168-179 |
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| container_end_page | 179 |
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| container_start_page | 168 |
| container_title | The American journal of surgery |
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| creator | Anyomih, Theophilus TK Jennings, Thomas Mehta, Alok O'Neill, J Robert Panagiotopoulou, Ioanna Gourgiotis, Stavros Tweedle, Elizabeth Bennett, John Davies, R Justin Simillis, Constantinos |
| description | Appendectomy is a benchmark operation for trainee progression, but this should be weighed against patient safety and perioperative outcomes.
Systematic literature review and meta-analysis comparing outcomes of appendectomy performed by trainees versus trained surgeons.
Of 2086 articles screened, 29 studies reporting on 135,358 participants were analyzed. There was no difference in mortality (Odds ratio [OR] 1.08, P = 0.830), overall complications (OR 0.93, P = 0.51), or major complications (OR 0.56, P = 0.16). There was no difference in conversion from laparoscopic to open surgery (OR 0.81, P = 0.12) and in intraoperative blood loss (Mean Difference [MD] 5.58 mL, P = 0.25). Trainees had longer operating time (MD 7.61 min, P |
| doi_str_mv | 10.1016/j.amjsurg.2022.07.006 |
| format | article |
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Systematic literature review and meta-analysis comparing outcomes of appendectomy performed by trainees versus trained surgeons.
Of 2086 articles screened, 29 studies reporting on 135,358 participants were analyzed. There was no difference in mortality (Odds ratio [OR] 1.08, P = 0.830), overall complications (OR 0.93, P = 0.51), or major complications (OR 0.56, P = 0.16). There was no difference in conversion from laparoscopic to open surgery (OR 0.81, P = 0.12) and in intraoperative blood loss (Mean Difference [MD] 5.58 mL, P = 0.25). Trainees had longer operating time (MD 7.61 min, P < 0.0001). Appendectomy by trainees resulted in shorter duration of hospital stay (MD 0.16 days, P = 0.005) and decreased reoperation rate (OR 0.78, P = 0.05).
Appendectomy performed by trainees does not compromise patient safety. Due to statistical heterogeneity, further randomized controlled trials, with standardized reported outcomes, are required.
•A systematic literature review and meta-analysis were performed.•Compared outcomes of appendectomy performed by trainees versus trained surgeons.•Included 29 studies, reporting on 135,358 participants•No difference in morbidity, operative blood loss, or conversion to open surgery.•Trainees had longer operating time, but shorter hospital stay and less reoperations.•Appendectomy performed by trainees does not compromise patient safety.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2022.07.006</identifier><identifier>PMID: 35927089</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdomen ; Abscesses ; Antibiotics ; Appendectomy ; Appendectomy - methods ; Appendicitis - surgery ; Bias ; Clinical outcomes ; Clinical trials ; Collaboration ; Complications ; Confidence intervals ; Heterogeneity ; Hospitals ; Humans ; Laparoscopy ; Length of Stay ; Literature reviews ; Meta-analysis ; Mortality ; Patient safety ; Patients ; Postoperative Complications - epidemiology ; Postoperative Complications - surgery ; Reoperation ; Safety ; Statistical analysis ; Surgeons ; Systematic review ; Training</subject><ispartof>The American journal of surgery, 2023-01, Vol.225 (1), p.168-179</ispartof><rights>2022 Elsevier Inc.</rights><rights>Copyright © 2022 Elsevier Inc. All rights reserved.</rights><rights>2022. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-fb5a40be76146777d2800bb4207813f63bb73b3e6674fc01bbf0bb8575ed86ef3</citedby><cites>FETCH-LOGICAL-c393t-fb5a40be76146777d2800bb4207813f63bb73b3e6674fc01bbf0bb8575ed86ef3</cites><orcidid>0000-0001-6684-5821 ; 0000-0001-8864-4350</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35927089$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anyomih, Theophilus TK</creatorcontrib><creatorcontrib>Jennings, Thomas</creatorcontrib><creatorcontrib>Mehta, Alok</creatorcontrib><creatorcontrib>O'Neill, J Robert</creatorcontrib><creatorcontrib>Panagiotopoulou, Ioanna</creatorcontrib><creatorcontrib>Gourgiotis, Stavros</creatorcontrib><creatorcontrib>Tweedle, Elizabeth</creatorcontrib><creatorcontrib>Bennett, John</creatorcontrib><creatorcontrib>Davies, R Justin</creatorcontrib><creatorcontrib>Simillis, Constantinos</creatorcontrib><title>Systematic review and meta-analysis comparing perioperative outcomes of emergency appendectomy performed by trainee vs trained surgeon</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Appendectomy is a benchmark operation for trainee progression, but this should be weighed against patient safety and perioperative outcomes.
Systematic literature review and meta-analysis comparing outcomes of appendectomy performed by trainees versus trained surgeons.
Of 2086 articles screened, 29 studies reporting on 135,358 participants were analyzed. There was no difference in mortality (Odds ratio [OR] 1.08, P = 0.830), overall complications (OR 0.93, P = 0.51), or major complications (OR 0.56, P = 0.16). There was no difference in conversion from laparoscopic to open surgery (OR 0.81, P = 0.12) and in intraoperative blood loss (Mean Difference [MD] 5.58 mL, P = 0.25). Trainees had longer operating time (MD 7.61 min, P < 0.0001). Appendectomy by trainees resulted in shorter duration of hospital stay (MD 0.16 days, P = 0.005) and decreased reoperation rate (OR 0.78, P = 0.05).
Appendectomy performed by trainees does not compromise patient safety. Due to statistical heterogeneity, further randomized controlled trials, with standardized reported outcomes, are required.
•A systematic literature review and meta-analysis were performed.•Compared outcomes of appendectomy performed by trainees versus trained surgeons.•Included 29 studies, reporting on 135,358 participants•No difference in morbidity, operative blood loss, or conversion to open surgery.•Trainees had longer operating time, but shorter hospital stay and less reoperations.•Appendectomy performed by trainees does not compromise patient safety.</description><subject>Abdomen</subject><subject>Abscesses</subject><subject>Antibiotics</subject><subject>Appendectomy</subject><subject>Appendectomy - methods</subject><subject>Appendicitis - surgery</subject><subject>Bias</subject><subject>Clinical outcomes</subject><subject>Clinical trials</subject><subject>Collaboration</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Heterogeneity</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Length of Stay</subject><subject>Literature reviews</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Patient safety</subject><subject>Patients</subject><subject>Postoperative Complications - 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Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anyomih, Theophilus TK</au><au>Jennings, Thomas</au><au>Mehta, Alok</au><au>O'Neill, J Robert</au><au>Panagiotopoulou, Ioanna</au><au>Gourgiotis, Stavros</au><au>Tweedle, Elizabeth</au><au>Bennett, John</au><au>Davies, R Justin</au><au>Simillis, Constantinos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systematic review and meta-analysis comparing perioperative outcomes of emergency appendectomy performed by trainee vs trained surgeon</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2023-01</date><risdate>2023</risdate><volume>225</volume><issue>1</issue><spage>168</spage><epage>179</epage><pages>168-179</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Appendectomy is a benchmark operation for trainee progression, but this should be weighed against patient safety and perioperative outcomes.
Systematic literature review and meta-analysis comparing outcomes of appendectomy performed by trainees versus trained surgeons.
Of 2086 articles screened, 29 studies reporting on 135,358 participants were analyzed. There was no difference in mortality (Odds ratio [OR] 1.08, P = 0.830), overall complications (OR 0.93, P = 0.51), or major complications (OR 0.56, P = 0.16). There was no difference in conversion from laparoscopic to open surgery (OR 0.81, P = 0.12) and in intraoperative blood loss (Mean Difference [MD] 5.58 mL, P = 0.25). Trainees had longer operating time (MD 7.61 min, P < 0.0001). Appendectomy by trainees resulted in shorter duration of hospital stay (MD 0.16 days, P = 0.005) and decreased reoperation rate (OR 0.78, P = 0.05).
Appendectomy performed by trainees does not compromise patient safety. Due to statistical heterogeneity, further randomized controlled trials, with standardized reported outcomes, are required.
•A systematic literature review and meta-analysis were performed.•Compared outcomes of appendectomy performed by trainees versus trained surgeons.•Included 29 studies, reporting on 135,358 participants•No difference in morbidity, operative blood loss, or conversion to open surgery.•Trainees had longer operating time, but shorter hospital stay and less reoperations.•Appendectomy performed by trainees does not compromise patient safety.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>35927089</pmid><doi>10.1016/j.amjsurg.2022.07.006</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-6684-5821</orcidid><orcidid>https://orcid.org/0000-0001-8864-4350</orcidid></addata></record> |
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| subjects | Abdomen Abscesses Antibiotics Appendectomy Appendectomy - methods Appendicitis - surgery Bias Clinical outcomes Clinical trials Collaboration Complications Confidence intervals Heterogeneity Hospitals Humans Laparoscopy Length of Stay Literature reviews Meta-analysis Mortality Patient safety Patients Postoperative Complications - epidemiology Postoperative Complications - surgery Reoperation Safety Statistical analysis Surgeons Systematic review Training |
| title | Systematic review and meta-analysis comparing perioperative outcomes of emergency appendectomy performed by trainee vs trained surgeon |
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