Complications of surgical endoscopy. A decade of experience from a surgical residency training program.
BACKGROUND
This study examines the notion that gastrointestinal endoscopy performed by supervised surgical residents is safe.


METHODS
We reviewed all gastrointestinal endoscopic procedures performed by surgical residents with faculty supervision for complications and deaths occurring up to 30 days following the procedures.


RESULTS
The overall complication rate for 9,201 upper and lower endoscopy procedures was 1.4% and 0.42%, respectively. Overall mortality rate was 0.76% for upper endoscopy and 0.6% for lower endoscopy. No mortality was a direct result of a procedure-related complication. Intestinal perforation, drug overdose, bleeding, and aspiration were the most common procedure-related complications. Each resident completed an average of 75 upper endoscopies and 79 lower endoscopies during their training period.


CONCLUSIONS
Gastrointestinal endoscopy can be performed safely by surgical residents with appropriate supervision. The higher morbidity and mortality of upper endoscopy are most likely related to the underlying disease rather than the procedure. Awareness of common complications and application of appropriate precautions and instruction are critical for minimizing complications.
Schauer
P R
PR
Department of Surgery, University of Pittsburgh Medical Center, PA 15213-3221, USA.
Schwesinger
W H
WH
Page
C P
CP
Stewart
R M
RM
Levine
B A
BA
Sirinek
K R
KR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D004724:Endoscopy / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications; D015397:Program Evaluation