Impact of tutorial assistance in laparoscopic sigmoidectomy for acute recurrent diverticulitis |
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Authors: | Henry Hoffmann Salome Dell-Kuster Jörg Genstorfer Oleg Heizmann Christoph Kettelhack Igor Langer Daniel Oertli Rachel Rosenthal |
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Institution: | 1. Department of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland 2. Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, 4031, Basel, Switzerland 3. Department of Surgery, Cantonal Hospital Bruderholz, 4101, Bruderholz, Switzerland
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Abstract: | Purpose Adequate training and close supervision by an experienced surgeon are crucial to assure the patient safety during laparoscopic training. This study evaluated the impact of tutorial assistance on the duration of surgery and postoperative complications after laparoscopic sigmoidectomy. Methods The data from 235 patients undergoing laparoscopic sigmoidectomy were collected. Operating surgeons were classified as either residents/registrars (group A, tutorial assistance) or consultants operating autonomously (group B). Groups were compared concerning the duration of surgery and in-hospital complications using a multivariable regression model accounting for the most relevant confounders. Results The median duration of the operation in group A (n = 75) was 221 min, and that in group B (n = 160) 189 min (p < 0.001). The risk of developing any in-hospital complication (Clavien–Dindo classification I–V) was 36.0 % in Group A and 32.5 % in group B (95 % CI ?16.6, 9.6 %). The risk of developing moderate to severe surgical complications (Clavien–Dindo classification II-V) was 16.0 % in group A and 12.5 % in group B (95 % CI ?13.3, 6.3 %). Conclusions We were unable to demonstrate a clear impact of tutorial assistance on the risk of postoperative complications. Although associated with a longer duration of surgery, laparoscopic sigmoidectomy for acute recurrent sigmoid diverticulitis conducted by a junior supervised surgeon appears to be a safe surgical modality. |
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