The Laboratory for Applied Cancer Research, Haifa, Israel.
Department of Otolaryngology-Head and Neck Surgery, The Head and Neck Center, Rambam Health Care Campus, Clinical Research Institute at Rambam, Rappaport Institute of Medicine and Research, The Technion, Israel Institute of Technology, Haifa, Israel.
Ann Otol Rhinol Laryngol. 2021 Dec;130(12):1340-1344. doi: 10.1177/00034894211007057. Epub 2021 Apr 7.
To assess whether a surgeon's level of training is associated with outcomes in pediatric tonsillectomy.
A retrospective cohort study of the outcomes of pediatric tonsillectomies performed between 2006 and 2016 by senior surgeons versus resident surgeons under the supervision of senior surgeons.
An otolaryngology department in a tertiary academic hospital.
Children younger than 18 years who underwent bilateral tonsillectomy with or without adenoidectomy.
Intraoperative bleeding, initiation of oral intake, and intraoperative and postoperative complications.
Of 785 children, 397 (50.5%) were operated on by a resident surgeon and 388 (49.5%) by a senior surgeon. Patient demographics and surgical techniques were similar between the groups. The mean surgical time was 33.2 minutes in the residents' group and 27.1 minutes in the seniors' group ( = .032). The groups were similar in intraoperative bleeding, while same-day initiation of oral intake was 71% for children in the residents' group versus 61% in the seniors' group ( = .28). Reports of postoperative bleeding necessitating readmission and revised operations were similar for both groups (3.0% and 0.7%, respectively, in the residents' group; and 2.5% and 1.0%, respectively, in the seniors' group).
Children undergoing tonsillectomy showed similar short-term outcomes, whether the operations were performed by a senior surgeon or a resident surgeon supervised by an attending surgeon. This study demonstrates the safety of pediatric tonsillectomy performed by resident surgeons supervised by attending physicians.
评估外科医生的培训水平是否与小儿扁桃体切除术的结果相关。
一项回顾性队列研究，比较了 2006 年至 2016 年间由高级外科医生与在高级外科医生监督下的住院医生进行的小儿扁桃体切除术的结果。
一家三级学术医院的耳鼻喉科。
年龄在 18 岁以下的接受双侧扁桃体切除术（伴或不伴腺样体切除术）的儿童。
术中出血、开始口服摄入、术中及术后并发症。
785 名儿童中，397 名（50.5%）由住院医生手术，388 名（49.5%）由高级医生手术。两组患者的人口统计学和手术技术相似。住院医生组的平均手术时间为 33.2 分钟，高级医生组为 27.1 分钟（ = .032）。两组的术中出血量相似，而住院医生组的儿童当天开始口服摄入的比例为 71%，高级医生组为 61%（ = .28）。两组术后出血需要再次入院和修正手术的报告相似（住院医生组分别为 3.0%和 0.7%，高级医生组分别为 2.5%和 1.0%）。
接受扁桃体切除术的儿童，无论手术是由高级外科医生还是由主治医生监督的住院医生进行，短期结果相似。本研究表明，由主治医生监督的住院医生进行小儿扁桃体切除术是安全的。
