Christopher B Allard1, Christian P Meyer2, Giorgio Gandaglia3, Steven L Chang4, Felix K H Chun5, Francisco Gelpi-Hammerschmidt6, Julian Hanske7, Adam S Kibel4, Mark A Preston4, Quoc-Dien Trinh4. 1. Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts; Division of Urology, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: callard@mgh.harvard.edu. 2. Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3. Division of Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy. 4. Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts. 5. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 6. Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts; Division of Urology, Massachusetts General Hospital, Boston, Massachusetts. 7. Center for Surgery and Public Health and Division of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Urology, Marien Hospital, Ruhr-University Bochum, Herne, Germany.
Abstract
OBJECTIVE: To conduct the first study of intra- and postoperative outcomes related to intraoperative resident involvement in transurethral resection procedures for benign prostatic hyperplasia and bladder cancer in a large, multi-institutional database. DESIGN: Relying on the American College of Surgeons National Surgical Quality Improvement Program Participant User Files (2005-2012), we abstracted all cases of endoscopic prostate surgery (EPS) for benign prostatic hyperplasia and transurethral resection of bladder tumors (TURBTs). Multivariable logistic regression models were constructed to assess the effect of trainee involvement (postgraduate year [PGY] 1-2: junior, PGY 3-4: senior, PGY ≥ 5: chief or fellow) vs attending only on operative time and length of hospital stay, as well as 30-day complication, reoperation, and readmission rates. RESULTS: In all, 5093 EPS and 3059 TURBTs for a total of 8152 transurethral resection procedures were performed during the study period for which data on resident involvement were available. In multivariable analyses, resident involvement in EPS or TURBT was associated with increased odds of prolonged operative times and hospital readmissions in 30 days independent of resident level of training. Resident involvement was not associated with overall complications or reoperation rates. CONCLUSIONS: Resident involvement in lower urinary tract surgeries is associated with increased readmissions. Strategies to optimize resident teaching of these common urologic procedures in order to minimize possible risks to patients should be explored.
OBJECTIVE: To conduct the first study of intra- and postoperative outcomes related to intraoperative resident involvement in transurethral resection procedures for benign prostatic hyperplasia and bladder cancer in a large, multi-institutional database. DESIGN: Relying on the American College of Surgeons National Surgical Quality Improvement Program Participant User Files (2005-2012), we abstracted all cases of endoscopic prostate surgery (EPS) for benign prostatic hyperplasia and transurethral resection of bladder tumors (TURBTs). Multivariable logistic regression models were constructed to assess the effect of trainee involvement (postgraduate year [PGY] 1-2: junior, PGY 3-4: senior, PGY ≥ 5: chief or fellow) vs attending only on operative time and length of hospital stay, as well as 30-day complication, reoperation, and readmission rates. RESULTS: In all, 5093 EPS and 3059 TURBTs for a total of 8152 transurethral resection procedures were performed during the study period for which data on resident involvement were available. In multivariable analyses, resident involvement in EPS or TURBT was associated with increased odds of prolonged operative times and hospital readmissions in 30 days independent of resident level of training. Resident involvement was not associated with overall complications or reoperation rates. CONCLUSIONS: Resident involvement in lower urinary tract surgeries is associated with increased readmissions. Strategies to optimize resident teaching of these common urologic procedures in order to minimize possible risks to patients should be explored.
Authors: Anna H de Vries; Arno M M Muijtjens; Hilde G J van Genugten; Ad J M Hendrikx; Evert L Koldewijn; Barbara M A Schout; Cees P M van der Vleuten; Cordula Wagner; Irene M Tjiam; Jeroen J G van Merriënboer Journal: Surg Endosc Date: 2018-06-05 Impact factor: 4.584
Authors: Blayne Welk; Jennifer Winick-Ng; Andrew McClure; Chris Vinden; Sumit Dave; Stephen Pautler Journal: Can Urol Assoc J Date: 2016 May-Jun Impact factor: 1.862
Authors: Kevin R Kasten; Adam C Celio; Lauren Trakimas; Mark L Manwaring; Konstantinos Spaniolas Journal: Surg Endosc Date: 2017-07-19 Impact factor: 4.584
Authors: Sarah H Bube; Pernille S Kingo; Mia G Madsen; Juan L Vásquez; Thomas Norus; Rikke G Olsen; Claus Dahl; Rikke B Hansen; Lars Konge; Nessn Azawi Journal: Eur Urol Open Sci Date: 2022-04-01