Holger Joswig1, Oliver P Gautschi2, Amir El Rahal2, Lukas Sveikata2, Andrea Bartoli2, Gerhard Hildebrandt1, Karl Schaller2, Martin N Stienen3. 1. Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. 2. Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland. 3. Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland. Electronic address: mnstienen@gmail.com.
Abstract
BACKGROUND: Patient safety aspects and the residents' role in spine surgery within a structured training program have recently been investigated. The current work deals with residency training safety aspects for cranioplasty (CP), a standard neurosurgical cranial procedure. METHODS: Retrospective 2-center study comparing consecutive patients undergoing CP by a supervised neurosurgery resident (teaching cases) with a consecutive series of patients operated on by a board-certified faculty neurosurgeon (nonteaching cases). The primary end point was occurrence of a postoperative complication. Secondary end points were severity (Ibañez degree) of postoperative complications, surgical site infections requiring CP removal and patients' clinical outcome measured with the modified Rankin Scale. RESULTS: A total of 240 CPs (137 teaching [57.1%] and 103 nonteaching [42.9%] cases) were analyzed. The mean teaching case operation time was longer (129.2 vs. 115.8 minutes; P < 0.001), and there was no difference in the estimated blood loss (mean 243.3 vs. 223.1 mL; P = 0.444). Supervised residents were as likely as board-certified faculty neurosurgeons to have a postoperative complication (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.42-1.39; P = 0.385) and the severity was comparable (Pearson χ(2) = 7.62; P = 0.106). Teaching cases were as likely as nonteaching cases to experience a surgical site infection requiring CP removal (OR, 1.66; 95% CI, 0.69-4.04; P = 0.261). Also, the likelihood for postoperative improvement on the modified Rankin Scale was similar for patients in both groups (OR, 1.11; 95% CI, 0.62-2.00; P = 0.719). CONCLUSIONS: A relatively simple cranial procedure, such as CP, can be safely performed by a supervised neurosurgery resident without increasing complications or compromising patients' outcomes.
BACKGROUND:Patient safety aspects and the residents' role in spine surgery within a structured training program have recently been investigated. The current work deals with residency training safety aspects for cranioplasty (CP), a standard neurosurgical cranial procedure. METHODS: Retrospective 2-center study comparing consecutive patients undergoing CP by a supervised neurosurgery resident (teaching cases) with a consecutive series of patients operated on by a board-certified faculty neurosurgeon (nonteaching cases). The primary end point was occurrence of a postoperative complication. Secondary end points were severity (Ibañez degree) of postoperative complications, surgical site infections requiring CP removal and patients' clinical outcome measured with the modified Rankin Scale. RESULTS: A total of 240 CPs (137 teaching [57.1%] and 103 nonteaching [42.9%] cases) were analyzed. The mean teaching case operation time was longer (129.2 vs. 115.8 minutes; P < 0.001), and there was no difference in the estimated blood loss (mean 243.3 vs. 223.1 mL; P = 0.444). Supervised residents were as likely as board-certified faculty neurosurgeons to have a postoperative complication (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.42-1.39; P = 0.385) and the severity was comparable (Pearson χ(2) = 7.62; P = 0.106). Teaching cases were as likely as nonteaching cases to experience a surgical site infection requiring CP removal (OR, 1.66; 95% CI, 0.69-4.04; P = 0.261). Also, the likelihood for postoperative improvement on the modified Rankin Scale was similar for patients in both groups (OR, 1.11; 95% CI, 0.62-2.00; P = 0.719). CONCLUSIONS: A relatively simple cranial procedure, such as CP, can be safely performed by a supervised neurosurgery resident without increasing complications or compromising patients' outcomes.
Authors: Flavio Vasella; Julia Velz; Marian C Neidert; Stephanie Henzi; Johannes Sarnthein; Niklaus Krayenbühl; Oliver Bozinov; Luca Regli; Martin N Stienen Journal: Sci Rep Date: 2019-01-30 Impact factor: 4.379
Authors: Felix C Stengel; Maria L Gandia-Gonzalez; Cristina C Aldea; Jiri Bartek; Diogo Belo; Netanel Ben-Shalom; María F De la Cerda-Vargas; Evangelos Drosos; Christian F Freyschlag; Stanislav Kaprovoy; Milan Lepic; Laura Lippa; Katrin Rabiei; Giovanni Raffa; Bayron A Sandoval-Bonilla; Michael Schwake; Toma Spiriev; Cesare Zoia; Martin N Stienen Journal: Brain Spine Date: 2022-08-15