The Kidney Transplant: Maintaining Excellent Outcomes While Increasing Skills Acquisition. J Surg Educ 2023 Dec;80(12):1850-1858
Date
09/23/2023Pubmed ID
37739890DOI
10.1016/j.jsurg.2023.08.013Scopus ID
2-s2.0-85171638404 (requires institutional sign-in at Scopus site)Abstract
OBJECTIVE/BACKGROUND: Kidney transplantation is a complex operation that incorporates multiple fundamental surgical techniques and is an excellent opportunity for surgical skill development during residency training. We hypothesized that increasing resident competency, measured as anastomosis time, could be demonstrated while maintaining high-quality surgical outcomes during the learning process.
METHODS: We performed a retrospective cohort study of surgical resident involvement in kidney transplantation and recorded the anastomosis time. The study population comprised adult, single organ kidney transplants (n = 2052) at a large academic transplant center between 2006 and 2019. Descriptive statistics included frequencies, medians, and means. A mixed model of anastomosis time on number of procedures was fitted. Poisson models were fitted with outcomes of the number of patients with delayed graft function and number of patients that underwent reoperation postoperatively, with the exposure being number of kidney transplants performed by resident.
RESULTS: Results from the mixed model suggest that as the number of times a resident performs the surgery increases, the time to conduct the operation decreases with statistical significance. The Poisson regression demonstrated no significant relationship between the operative volume of a resident and postoperative complications.
CONCLUSION: This study demonstrated statistical evidence that with an increase in the number of renal transplantations performed by a surgical resident, anastomosis time decreased. It also demonstrated no significant relationship between number of kidney transplants performed by a resident and postoperative complications, suggesting that patient outcomes for this operation are not adversely affected by resident involvement.
Author List
Rausch LA, McKay KG, Liu Y, Walker JC, LeCompte MT, Ewing JK, Walia S, Davidson M, Forbes RC, Shaffer D, Terhune KPAuthor
Jasmine Walker MD, MPH Assistant Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultHumans
Internship and Residency
Kidney Transplantation
Postoperative Complications
Retrospective Studies
Treatment Outcome
