The following is a summary of “Comparison of perioperative outcomes of emergency Hartmann resections performed by residents versus attending surgeons,” published in the November 2024 issue of Surgery by Orbach et al.
The optimal level of resident involvement in emergency colorectal surgery remains unclear.
Researchers conducted a retrospective study to assess perioperative outcomes of emergency Hartmann resections in patients performed by residents versus attending surgeons.
They analyzed a tertiary teaching hospital, including 360 patients who underwent emergency colectomy with end stoma between the years 2013 and 2023. The outcomes were compared in patients with and without an attending surgeon present, using the Clavien-Dindo classification and other perioperative metrics.
The results showed that of 360 patients, 36 (10%) had surgery without an attending surgeon. Baseline characteristics, such as age (P=0.34), Charlson Comorbidity Index (CCI) (P=0.313), and sex (P=0.598), were similar across groups. Perioperative outcomes, including significant complications (Clavien-Dindo ≥3, P=0.176), 90-day complication rate (P=0.698), and 90-day mortality (P=0.389), showed no significant differences. Malignancy-related cases also showed no differences in lymph node yield (P=0.685) or overall survival (log-rank P=0.574).
They concluded that increasing resident autonomy in emergency Hartmann resections does not compromise perioperative or oncologic outcomes.
Source: americanjournalofsurgery.com/article/S0002-9610(24)00636-6/abstract
