The following is a summary of “Systematic review and meta-analysis comparing perioperative outcomes of emergency appendectomy performed by trainee vs trained surgeon,” published in the JANUARY 2023 issue of Surgery by Anyomih, et al.
Although appendectomy is a benchmark for trainee advancement, patient safety and postoperative outcomes should also be considered.
It was a systematic evaluation of the literature and meta-analysis comparing the results of appendectomy performed by inexperienced surgeons versus experienced surgeons.
About 29 research including 135,358 people, were examined out of the 2,086 papers that were reviewed. Mortality (Odds ratio [OR] 1.08, P = 0.830), general complications (OR 0.93, P = 0.51), or significant complications (OR 0.56, P = 0.16) did not differ from each other. Both the conversion rate from laparoscopic to open surgery (OR 0.81, P = 0.12) and intraoperative blood loss (MD 5.58 mL, P = 0.25) were similar. However, the operation time was longer for trainees (MD 7.61 min, P< 0.0001).
Trainees who performed appendectomies had shorter hospital stays (MD 0.16 days, P = 0.005) and lower reoperation rates (OR 0.78, P = 0.05).
Appendectomy procedures carried out by trainees did not jeopardize patient safety. However, there was a need for additional randomized controlled trials with standardized reported outcomes due to statistical heterogeneity.
Reference: americanjournalofsurgery.com/article/S0002-9610(22)00451-2/fulltext
