Analysis of surgical complications and patient outcomes in a residency training program.
OBJECTIVE
This study compares surgical complications and patient outcomes between pelvic reconstructive surgery performed by an experienced surgeon (group 1) and those performed by resident physicians with the senior surgeon assisting and teaching (group 2).


METHODS
During a 5-year interval, 310 consecutive women underwent vaginal prolapse repair. Demographic, historic, and preoperative physical examination variables were compared. Intraoperative and postoperative outcomes were also compared.


RESULTS
Patients operated on by the senior surgeon (Bob L. Shull) were thinner (group 1 vs group 2: 25.8 kg/m2 vs 27.1 kg/m2; P =.014), more often had prior prolapse or incontinence procedures (55% vs 33%; P <.001), and required shorter operating times (124 minutes vs 140 minutes; P =.002). The senior surgeon's patients differed from the resident physicians' patients with regard to stage of pelvic organ prolapse. No differences were observed for patient age (P =.51), estimated blood loss (P =.50), urologic complications (P =.59), and hospital stay (P =.25). The durability of the repairs was not different between the groups.


CONCLUSIONS
We have demonstrated that in a tertiary referral practice resident surgeons can be taught to perform complex vaginal surgery with the only observed disadvantage being a slightly prolonged operative time.
Coates
K W
KW
Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Scott and White Clinic and Memorial Hospital, Texas A&M University System Health Science Center College of Medicine, Temple 76508, USA.
Kuehl
T J
TJ
Bachofen
C G
CG
Shull
B L
BL
D000368:Aged; D016063:Blood Loss, Surgical; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006176:Gynecology / Q000379:methods*; D006801:Humans; D015994:Incidence; D007396:Internship and Residency / Q000379:methods*; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014570:Urologic Diseases / Q000453:epidemiology / Q000209:etiology; D014596:Uterine Prolapse / Q000601:surgery*