Impact of trainees involvement on surgical outcomes of abdominal and laparoscopic myomectomy
Background To determine the association of trainees involvement with surgical outcomes of abdominal and laparoscopic myomectomy including operative time, rate of transfusion, and complications.Methods A retrospective cohort study of 1145 patients who underwent an abdominal or laparoscopic myomectomy...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Journal of Obstetrics and Gynaecology |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/01443615.2024.2330697 |
| _version_ | 1826893623717789696 |
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| author | Olga M. Fajardo Ekaterina Grebenyuk Katherine F. Chaves Zhiguo Zhao Tan Ding Howard L. Curlin Lara F.B Harvey |
| author_facet | Olga M. Fajardo Ekaterina Grebenyuk Katherine F. Chaves Zhiguo Zhao Tan Ding Howard L. Curlin Lara F.B Harvey |
| author_sort | Olga M. Fajardo |
| collection | DOAJ |
| description | Background To determine the association of trainees involvement with surgical outcomes of abdominal and laparoscopic myomectomy including operative time, rate of transfusion, and complications.Methods A retrospective cohort study of 1145 patients who underwent an abdominal or laparoscopic myomectomy from 2008–2012 using the American College of Surgeons National Surgical Quality Improvement Program database (Canadian Task Force Classification II-2).Results Overall, 64% of myomectomies involved trainees. Trainees involvement was associated with a longer operative time for abdominal myomectomies (mean difference 20.17 minutes, 95% Confidence Interval (CI) [11.37,28.97], p < 0.01) overall and when stratified by fibroid burden. For laparoscopic myomectomy, there was no difference in operative time between trainees vs no trainees involvement (mean difference 4.64 minutes, 95% CI [−18.07,27.35], p = 0.67). There was a higher rate of transfusion with trainees involvement for abdominal myomectomies (10% vs 2%, p < 0.01; Odds Ratio (OR) 5.62, 95% CI [2.53,12.51], p < 0.01). Trainees involvement was not found to be associated with rate of transfusion for laparoscopic myomectomy (4% vs 5%, p = 0.86; OR 0.82, 95% CI [0.16,4.14], p = 0.81). For abdominal myomectomy, there was a higher rate of overall complications (15% vs 5%, p < 0.01; OR 2.96, 95% CI [1.77,4.93], p < 0.01) and minor complications (14% vs 4%, p < 0.01; OR 3.71, 95% CI [2.09,6.57], p < 0.01) with no difference in major complications (3% vs 2%, p = 0.23). For laparoscopic myomectomy, there was no difference in overall (6% vs 10% p = 0.41; OR 0.59, 95% CI [0.18,2.01], p = 0.40), major (2% vs 0%, p = 0.38), or minor (5% vs 10%, p = 0.32; OR 0.52, 95% CI [0.15,1.79], p = 0.30) complications.Conclusion Trainees involvement was associated with increased operative time, rate of transfusion, and complications for abdominal myomectomy, however, did not impact surgical outcomes for laparoscopic myomectomy. |
| first_indexed | 2024-04-24T20:11:36Z |
| format | Article |
| id | doaj.art-ff86371c399745f79c770ef18d267cc0 |
| institution | Directory Open Access Journal |
| issn | 0144-3615 1364-6893 |
| language | English |
| last_indexed | 2025-02-17T04:57:55Z |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Obstetrics and Gynaecology |
| spelling | doaj.art-ff86371c399745f79c770ef18d267cc02025-01-09T12:13:18ZengTaylor & Francis GroupJournal of Obstetrics and Gynaecology0144-36151364-68932024-12-0144110.1080/01443615.2024.2330697Impact of trainees involvement on surgical outcomes of abdominal and laparoscopic myomectomyOlga M. Fajardo0Ekaterina Grebenyuk1Katherine F. Chaves2Zhiguo Zhao3Tan Ding4Howard L. Curlin5Lara F.B Harvey6Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USADepartment of Obstetrics and Gynecology, Lankenau Medical Center, Wynnewood, PA, USAMinimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Main Line Health, Wynnewood, PA, USADepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USADepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USAMinimally Invasive Gynecologic Surgery Division, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USAMinimally Invasive Gynecologic Surgery Division, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USABackground To determine the association of trainees involvement with surgical outcomes of abdominal and laparoscopic myomectomy including operative time, rate of transfusion, and complications.Methods A retrospective cohort study of 1145 patients who underwent an abdominal or laparoscopic myomectomy from 2008–2012 using the American College of Surgeons National Surgical Quality Improvement Program database (Canadian Task Force Classification II-2).Results Overall, 64% of myomectomies involved trainees. Trainees involvement was associated with a longer operative time for abdominal myomectomies (mean difference 20.17 minutes, 95% Confidence Interval (CI) [11.37,28.97], p < 0.01) overall and when stratified by fibroid burden. For laparoscopic myomectomy, there was no difference in operative time between trainees vs no trainees involvement (mean difference 4.64 minutes, 95% CI [−18.07,27.35], p = 0.67). There was a higher rate of transfusion with trainees involvement for abdominal myomectomies (10% vs 2%, p < 0.01; Odds Ratio (OR) 5.62, 95% CI [2.53,12.51], p < 0.01). Trainees involvement was not found to be associated with rate of transfusion for laparoscopic myomectomy (4% vs 5%, p = 0.86; OR 0.82, 95% CI [0.16,4.14], p = 0.81). For abdominal myomectomy, there was a higher rate of overall complications (15% vs 5%, p < 0.01; OR 2.96, 95% CI [1.77,4.93], p < 0.01) and minor complications (14% vs 4%, p < 0.01; OR 3.71, 95% CI [2.09,6.57], p < 0.01) with no difference in major complications (3% vs 2%, p = 0.23). For laparoscopic myomectomy, there was no difference in overall (6% vs 10% p = 0.41; OR 0.59, 95% CI [0.18,2.01], p = 0.40), major (2% vs 0%, p = 0.38), or minor (5% vs 10%, p = 0.32; OR 0.52, 95% CI [0.15,1.79], p = 0.30) complications.Conclusion Trainees involvement was associated with increased operative time, rate of transfusion, and complications for abdominal myomectomy, however, did not impact surgical outcomes for laparoscopic myomectomy.https://www.tandfonline.com/doi/10.1080/01443615.2024.2330697NSQIPgynaecology surgeryfibroidssurgical educationsurgical complications |
| spellingShingle | Olga M. Fajardo Ekaterina Grebenyuk Katherine F. Chaves Zhiguo Zhao Tan Ding Howard L. Curlin Lara F.B Harvey Impact of trainees involvement on surgical outcomes of abdominal and laparoscopic myomectomy Journal of Obstetrics and Gynaecology NSQIP gynaecology surgery fibroids surgical education surgical complications |
| title | Impact of trainees involvement on surgical outcomes of abdominal and laparoscopic myomectomy |
| title_full | Impact of trainees involvement on surgical outcomes of abdominal and laparoscopic myomectomy |
| title_fullStr | Impact of trainees involvement on surgical outcomes of abdominal and laparoscopic myomectomy |
| title_full_unstemmed | Impact of trainees involvement on surgical outcomes of abdominal and laparoscopic myomectomy |
| title_short | Impact of trainees involvement on surgical outcomes of abdominal and laparoscopic myomectomy |
| title_sort | impact of trainees involvement on surgical outcomes of abdominal and laparoscopic myomectomy |
| topic | NSQIP gynaecology surgery fibroids surgical education surgical complications |
| url | https://www.tandfonline.com/doi/10.1080/01443615.2024.2330697 |
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