title: Does surgeon fatigue influence outcomes after anterior resection for rectal cancer?
abstract: BACKGROUND
  The long work hours in surgery may contribute to medical errors and impact patient outcomes. To date, there are no studies investigating outcomes related to fatigue in general surgery.
  
  
  METHODS
  All patients undergoing anterior resection between 1994 and 2005 at 2 university hospitals were identified. Cases were categorized as fatigued or nonfatigued and then compared with respect to complications and cancer recurrence.
  
  
  RESULTS
  Two hundred seventy patients underwent anterior resection during the study period. Of these, 22 were performed when the surgeon was fatigued. The fatigued and nonfatigued groups had similar preoperative characteristics. The rates of intraoperative complications (fatigued 14%, rested 18%, P = .58), major postoperative complications (fatigued 9%, rested 15%, P = .68), long-term complications (fatigued 31%, rested 31%, P = .9), and local cancer recurrence rates (fatigued 0%, rested 7%, P = .2) were not significantly different between the 2 groups.
  
  
  CONCLUSIONS
  Surgeon fatigue did not influence outcomes after anterior resection for rectal cancer.
authors.affiliation: Department of Surgery, University of Calgary, Tom Baker Cancer Center, 1331 29th Street NW, Calgary, Alberta T2N 2N4, Canada.
authors.forename: Colin
authors.initials: C
authors.lastname: Schieman
authors.forename: Anthony R
authors.initials: AR
authors.lastname: MacLean
authors.forename: W Donald
authors.initials: WD
authors.lastname: Buie
authors.forename: Luke R
authors.initials: LR
authors.lastname: Rudmik
authors.forename: William A
authors.initials: WA
authors.lastname: Ghali
authors.forename: Elijah
authors.initials: E
authors.lastname: Dixon
mesh_terms: D002983:Clinical Competence; D005221:Fatigue; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D016526:Workload