Read Joshua, Johns Jonathan, Anderson Cain, Prasad Jagdish
Ophthalmology, Rotorua Eye Clinic, Rotorua, NZL.
General Surgery, Te Whatu Ora, Tauranga, NZL.
Cureus. 2024 Nov 27;16(11):e74612. doi: 10.7759/cureus.74612. eCollection 2024 Nov.
Background Appendicectomies are the most frequently performed acute general surgery. The risk of complications depends on several factors, including patient age, American Society of Anesthesiologists (ASA), duration of symptoms, serum inflammatory markers, and the grade of inflammation. Prior research failed to demonstrate a relationship between the rate of complications and the surgeon's level of experience. It is unclear if the assistant's level of experience influences complication rates. Methods We conducted a retrospective cohort study to investigate the relationship between the surgeon's and assistant's position and the rate of complications following appendicectomy. We also explored whether more experienced staff were involved in higher-risk cases and their relationship with resource utilization. Results There was no significant difference in total complication rates based on the surgeon's and assistant's position (p = 0.48 and p = 0.99, respectively). Post-operative bleeding was the only complication that correlated with the assistant's level of experience (p = 0.002). More experienced surgeons performed faster appendicectomies (p =0.002), while the assistant's position had no influence (p = 0.47). There was no statistically significant relationship between the surgeon's and assistant's position, and post-operative length of admission, or risk factors for complications as measured by age, days of abdominal pain, white blood cell count (WCC), C-reactive protein (CRP), ASA, radiographic and intra-operative American Association for the Surgery of Trauma (AAST). Conclusion Experienced surgeons performed faster appendicectomies. There was a trend toward higher rates of post-operative bleeding with less experienced assistants. Otherwise, there was no relationship between the surgeon's experience level and post-appendicectomy complication rates, length of post-operative stay, or patient risk factors for complications.
阑尾切除术是最常施行的急性普通外科手术。并发症的风险取决于多个因素，包括患者年龄、美国麻醉医师协会（ASA）分级、症状持续时间、血清炎症标志物以及炎症分级。先前的研究未能证明并发症发生率与外科医生的经验水平之间存在关联。尚不清楚助手的经验水平是否会影响并发症发生率。方法：我们进行了一项回顾性队列研究，以调查外科医生和助手的职位与阑尾切除术后并发症发生率之间的关系。我们还探讨了经验更丰富的工作人员是否参与了更高风险的病例以及他们与资源利用的关系。结果：基于外科医生和助手的职位，总并发症发生率没有显著差异（分别为p = 0.48和p = 0.99）。术后出血是唯一与助手经验水平相关的并发症（p = 0.002）。经验更丰富的外科医生进行阑尾切除术的速度更快（p = 0.002），而助手的职位没有影响（p = 0.47）。外科医生和助手的职位与术后住院时间或并发症风险因素（通过年龄、腹痛天数、白细胞计数（WCC）、C反应蛋白（CRP）、ASA、影像学检查和术中美国创伤外科协会（AAST）测量）之间没有统计学上的显著关系。结论：经验丰富的外科医生进行阑尾切除术的速度更快。经验较少的助手术后出血率有升高的趋势。否则，外科医生的经验水平与阑尾切除术后并发症发生率、术后住院时间或患者并发症风险因素之间没有关系。
