title: Outcomes associated with resident involvement in partial colectomy.
abstract: BACKGROUND
  Surgical cases that include trainees are associated with worse outcomes in comparison with those that include attending surgeons alone.
  
  
  OBJECTIVE
  This study aimed to identify whether resident involvement in partial colectomy was associated with worse outcomes when evaluated by surgical approach and resident experience.
  
  
  METHODS
  This is a retrospective study using the National Surgical Quality Improvement Program database.
  
  
  METHODS
  This study evaluates cases included in the National Surgical Quality Improvement Program database.
  
  
  METHODS
  All patients were included who underwent partial colectomy including both open and laparoscopic approaches.
  
  
  METHODS
  Residents were involved.
  
  
  METHODS
  The primary outcome measures were the association of resident involvement and major complication events, minor complication events, unplanned return to operating room, and operative time.
  
  
  RESULTS
  Cases with residents were associated with major complications (OR 1.18, CI 1.09-1.27, p < 0.001) on multivariate analysis. However, after including operative time in the model only open cases involving fifth year residents were still associated with major complications (OR 1.13, p = 0.037). Resident involvement was associated with increased likelihood of minor complications (OR 1.3, p < 0.001) and an increased risk of unplanned return to the operating room (OR 1.20, p < 0.001). Operative time was longer for cases with residents on average by 33.7 minutes and 27 minutes for open and laparoscopic cases.
  
  
  CONCLUSIONS
  This study was limited by its retrospective design and lack of data on teachings status, case complexity, and intraoperative evaluation of technique.
  
  
  CONCLUSIONS
  Resident involvement in partial colectomies is associated with an increased major complications, minor complications, likelihood of return to the operating room, and operative time.
authors.affiliation: Surgical Health Outcomes & Research Enterprise, University of Rochester Medical Center, Rochester, New York 14642, USA. james_iannuzzi@urmc.rochester.edu
authors.forename: James C
authors.initials: JC
authors.lastname: Iannuzzi
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Rickles
authors.forename: Andrew-Paul
authors.initials: AP
authors.lastname: Deeb
authors.forename: Abhiram
authors.initials: A
authors.lastname: Sharma
authors.forename: Fergal J
authors.initials: FJ
authors.lastname: Fleming
authors.forename: John R T
authors.initials: JR
authors.lastname: Monson
mesh_terms: D000368:Aged; D002983:Clinical Competence; D003082:Colectomy / Q000009:adverse effects; D003108:Colonic Diseases / Q000453:epidemiology / Q000601:surgery; D015897:Comorbidity; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology; D058996:Quality Improvement; D012189:Retrospective Studies