title: Does resident involvement effect surgical times and complication rates during laparoscopic appendectomy for uncomplicated appendicitis? An analysis of 16,849 cases from the ACS-NSQIP.
abstract: BACKGROUND
  Controversy exists regarding whether resident involvement during surgery impacts patient outcomes. We compared surgical times and perioperative complications of patients undergoing laparoscopic appendectomy with and without residents.
  
  
  METHODS
  Patients undergoing laparoscopic appendectomy for uncomplicated acute appendicitis during 2005 to 2008 were identified from the American College of Surgeons National Surgical Quality Improvement Program database.
  
  
  RESULTS
  During the study period, 16,849 patients underwent laparoscopic appendectomy for uncomplicated appendicitis (residents participated in 68% of procedures). There were no statistical and/or clinically meaningful differences between median age, sex, body mass index, American Society of Anesthesiology score, and morbidity probability between the 2 groups, suggesting that case mix was not a significant confounder. Patients undergoing laparoscopic appendectomy with residents compared with patients undergoing laparoscopic appendectomy without residents had a higher incidence of serious and overall morbidity and longer surgical times. However, surgical times and complications were similar between residents in postgraduate years 1 to 5.
  
  
  CONCLUSIONS
  Regardless of the postgraduate year level, resident involvement resulted in a clinically appreciable increase in surgical times and a statistically significant increase in certain complications.
authors.affiliation: Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL 62704, USA.
authors.forename: Vriti
authors.initials: V
authors.lastname: Advani
authors.forename: Sajida
authors.initials: S
authors.lastname: Ahad
authors.forename: Chad
authors.initials: C
authors.lastname: Gonczy
authors.forename: Steven
authors.initials: S
authors.lastname: Markwell
authors.forename: Imran
authors.initials: I
authors.lastname: Hassan
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000193:education / Q000592:standards*; D001064:Appendicitis / Q000601:surgery*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011787:Quality of Health Care; D013997:Time Factors; D014481:United States