Safety assessment of open appendectomies for complicated acute appendicitis in children: a comparison of trainees and specialists

Pediatr Surg Int. 2020 Oct;36(10):1181-1187. doi: 10.1007/s00383-020-04713-0. Epub 2020 Jul 16.

Abstract

Purpose: The aim of this study was to compare the outcome of children with complicated acute appendicitis (CAA) who underwent open appendectomy (OA) performed either by trainees under the direct supervision of an SPS, or an SPS.

Methods: Two hundred thirty eight patients with CAA were reviewed operated on either by a junior trainee (JT) or a senior trainee (ST) under the direct supervision of an SPS or by an SPS. The outcome measures were the overall rate of complications, operative time (OT), length of hospital stay (LHS) and 30-day readmission rate.

Results: No statistical differences were observed between the three groups regarding the overall complication rates and 30-day readmission rate. Although, no statistical differences were observed in the mean OT between the three groups, the mean OT for perforated appendicitis (PA) performed by JTs was significantly longer than when performed by SPSs (p 0.012). Furthermore, there was a statistically significant difference between JTs and SPSs in terms of LHS for patients with PA (p 0.028).

Conclusion: This study suggests that no statistical differences were observed between the supervised trainees and SPSs regarding the overall complication rate and 30-readmission rate when they performed OA for GA or PA except of a longer OT and LHS for PA performed by JTs.

Keywords: Appendectomy; Children; Complicated acute appendicitis; Outcomes; Trainee.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Appendectomy / methods*
  • Appendicitis / surgery*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy / methods*
  • Length of Stay
  • Male
  • Operative Time
  • Outcome Assessment, Health Care
  • Patient Readmission
  • Retrospective Studies
  • Specialization*