title: Comparison of pediatric appendectomy outcomes between pediatric surgeons and general surgery residents.
abstract: BACKGROUND
  Appendectomy is the most common urgent procedure in children, and surgical outcomes may be affected by the surgeon's experience. This study's aim is to compare appendectomy outcomes performed by pediatric surgeons (PSs) and general surgery residents (GSRs).
  
  
  METHODS
  A retrospective review of all patients younger than 16y treated for appendicitis at two different campuses of the same institution during the years 2008-2009 was performed. Appendectomies were performed by PS in one campus and GSR in the other. Primary end points included postoperative morbidity and hospital length of stay.
  
  
  RESULTS
  During the study period, 246 (61%) patients were operated by senior GSR (postgraduate year 5-7) versus 157 (39%) patients by PS. There was no significant difference in patients' characteristics at presentation to the emergency room and the rate of appendeceal perforation (11% versus 15%, P=0.32), and noninfectious appendicitis (5% versus 5% P=0.78) also was similar. Laparoscopic surgery was performed more commonly by GSR (16% versus 9%, P=0.02) with shorter operating time (54±1.5 versus 60±2.1, P=0.01). Interestingly, the emergency room to operating room time was shorter for GSR group (419±14 versus 529±24min, P<0.001). The hospital length of stay was shorter for the GSR group (4.0±0.2 versus 4.5±0.2, P=0.03), and broad-spectrum antibiotics were used less commonly (20% versus 53%, P<0.0001) and so was home antibiotics continuation (13% versus 30%, P<0.0001). Nevertheless, postoperative complication rate was similar (5% versus 7%, P=0.29) and so was the rate of readmissions (2% versus 5%, P=0.52).
  
  
  CONCLUSIONS
  The results of this study suggest that the presence of a PS does not affect the outcomes of appendectomies.
authors.affiliation: Department of Surgery, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel.
authors.forename: Ido
authors.initials: I
authors.lastname: Mizrahi
authors.forename: Haggi
authors.initials: H
authors.lastname: Mazeh
authors.forename: Yair
authors.initials: Y
authors.lastname: Levy
authors.forename: Gilad
authors.initials: G
authors.lastname: Karavani
authors.forename: Muhammad
authors.initials: M
authors.lastname: Ghanem
authors.forename: Yaron
authors.initials: Y
authors.lastname: Armon
authors.forename: Amos
authors.initials: A
authors.lastname: Vromen
authors.forename: Ahmed
authors.initials: A
authors.lastname: Eid
authors.forename: Raphael
authors.initials: R
authors.lastname: Udassin
mesh_terms: D001062:Appendectomy / Q000009:adverse effects; D002648:Child; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D010372:Pediatrics / Q000193:education*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome