Resident postgraduate year does not influence rate of complications following inguinal herniorrhaphy

Oswaldo Renteria, Ali A. Mokdad, Jonathan Imran, Sergio Huerta

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Previous data indicate that patients who undergo surgery with a postgraduate year 3 (PGY-3) resident as the junior surgeon have a lower rate of recurrence compared with PGY-1 and PGY-2 after an open inguinal herniorrhaphy. Lower PGY level was also associated with increased operative time. We hypothesize that when controlling for surgeon, technique, and hernia type, the outcomes for inguinal herniorrhaphy are the same independent of PGY level. Materials and methods A retrospective review of all open unilateral inguinal hernia repairs done by residents who assisted the same senior surgeon at the Veterans Affairs North Texas Health Care System was performed. Results Seven hundred fifty-two open unilateral inguinal hernia were identified: mean patient age = 60.6 ± 12.7 y; mean body mass index = 27.0 ± 10.8 kg/m2; American Society of Anesthesia III-IV = 51%; and Nyhus type 2 = 44.7%, 3a = 41.6%, and 3b = 13.7%. Residents involved were PGY-1 (17.2%), PGY-2/3 (71.1%), and PGY-4/5 (11.7%). Postoperative complications for intern, junior (PGY-2 and PGY-3), and senior residents (PGY-4 and PGY-5) were 4%, 9%, and 6%, respectively (P = 0.14). Compared to interns, junior residents finished the operation 3.9 min faster (95% confidence interval = −7.5, −0.3). There was no time difference between interns and senior residents completing the operations after controlling for hernia type. Logistic regression did not identify PGY level as an independent predictor of complications or recurrence. Conclusions There was a slight decrease in operative time when the repair was done with junior-level residents. PGY level did not influence outcomes for open, unilateral inguinal herniorrhaphy when controlled for hernia type and technique.

Original languageEnglish (US)
Pages (from-to)61-65
Number of pages5
JournalJournal of Surgical Research
Volume219
DOIs
StatePublished - Nov 1 2017

Fingerprint

Groin
Herniorrhaphy
Inguinal Hernia
Operative Time
Hernia
Recurrence
Veterans
Body Mass Index
Anesthesia
Logistic Models
Confidence Intervals
Delivery of Health Care
Surgeons

Keywords

  • Inguinal hernia
  • PGY
  • Resident training
  • Surgical education

ASJC Scopus subject areas

  • Surgery

Cite this

Resident postgraduate year does not influence rate of complications following inguinal herniorrhaphy. / Renteria, Oswaldo; Mokdad, Ali A.; Imran, Jonathan; Huerta, Sergio.

In: Journal of Surgical Research, Vol. 219, 01.11.2017, p. 61-65.

Research output: Contribution to journalArticle

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title = "Resident postgraduate year does not influence rate of complications following inguinal herniorrhaphy",
abstract = "Background Previous data indicate that patients who undergo surgery with a postgraduate year 3 (PGY-3) resident as the junior surgeon have a lower rate of recurrence compared with PGY-1 and PGY-2 after an open inguinal herniorrhaphy. Lower PGY level was also associated with increased operative time. We hypothesize that when controlling for surgeon, technique, and hernia type, the outcomes for inguinal herniorrhaphy are the same independent of PGY level. Materials and methods A retrospective review of all open unilateral inguinal hernia repairs done by residents who assisted the same senior surgeon at the Veterans Affairs North Texas Health Care System was performed. Results Seven hundred fifty-two open unilateral inguinal hernia were identified: mean patient age = 60.6 ± 12.7 y; mean body mass index = 27.0 ± 10.8 kg/m2; American Society of Anesthesia III-IV = 51{\%}; and Nyhus type 2 = 44.7{\%}, 3a = 41.6{\%}, and 3b = 13.7{\%}. Residents involved were PGY-1 (17.2{\%}), PGY-2/3 (71.1{\%}), and PGY-4/5 (11.7{\%}). Postoperative complications for intern, junior (PGY-2 and PGY-3), and senior residents (PGY-4 and PGY-5) were 4{\%}, 9{\%}, and 6{\%}, respectively (P = 0.14). Compared to interns, junior residents finished the operation 3.9 min faster (95{\%} confidence interval = −7.5, −0.3). There was no time difference between interns and senior residents completing the operations after controlling for hernia type. Logistic regression did not identify PGY level as an independent predictor of complications or recurrence. Conclusions There was a slight decrease in operative time when the repair was done with junior-level residents. PGY level did not influence outcomes for open, unilateral inguinal herniorrhaphy when controlled for hernia type and technique.",
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AB - Background Previous data indicate that patients who undergo surgery with a postgraduate year 3 (PGY-3) resident as the junior surgeon have a lower rate of recurrence compared with PGY-1 and PGY-2 after an open inguinal herniorrhaphy. Lower PGY level was also associated with increased operative time. We hypothesize that when controlling for surgeon, technique, and hernia type, the outcomes for inguinal herniorrhaphy are the same independent of PGY level. Materials and methods A retrospective review of all open unilateral inguinal hernia repairs done by residents who assisted the same senior surgeon at the Veterans Affairs North Texas Health Care System was performed. Results Seven hundred fifty-two open unilateral inguinal hernia were identified: mean patient age = 60.6 ± 12.7 y; mean body mass index = 27.0 ± 10.8 kg/m2; American Society of Anesthesia III-IV = 51%; and Nyhus type 2 = 44.7%, 3a = 41.6%, and 3b = 13.7%. Residents involved were PGY-1 (17.2%), PGY-2/3 (71.1%), and PGY-4/5 (11.7%). Postoperative complications for intern, junior (PGY-2 and PGY-3), and senior residents (PGY-4 and PGY-5) were 4%, 9%, and 6%, respectively (P = 0.14). Compared to interns, junior residents finished the operation 3.9 min faster (95% confidence interval = −7.5, −0.3). There was no time difference between interns and senior residents completing the operations after controlling for hernia type. Logistic regression did not identify PGY level as an independent predictor of complications or recurrence. Conclusions There was a slight decrease in operative time when the repair was done with junior-level residents. PGY level did not influence outcomes for open, unilateral inguinal herniorrhaphy when controlled for hernia type and technique.

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