Effects of Surgical Assistant’s Level of Resident Training on Surgical Treatment of Intermittent Exotropia: Operation Time and Surgical Outcomes
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
To evaluate the effects of the surgical assistant’s level of resident training on operation time and surgicaloutcome in the surgical treatment of intermittent exotropia. Methods: This study included 456 patients with intermittent exotropia who underwent lateral rectus recessionand medial rectus resection and were followed up for 24 months after surgery. The patients were divided intotwo groups according to the surgical assistant’s level of resident training: group F (surgery assisted by a firstyearresident [n = 198]) and group S (surgery assisted by a second-, third-, or fourth-year resident [n = 258]). The operation time and surgical outcomes (postoperative exodeviation and the number of patients who underwenta second operation) were compared between the two groups. Results: The average operation times in groups F and S were 36.54 ± 7.4 and 37.34 ± 9.94 minutes, respectively(p = 0.33). Immediate postoperative exodeviation was higher in group F (0.79 ± 3.82 prism diopters) than ingroup S (0.38 ± 3.75 prism diopters). However, repeated-measures analysis of variance revealed no significantdifference in exodeviation between the two groups during the 24-month follow-up period (p = 0.45). A secondoperation was performed in 29.3% (58 / 198) of the patients in group F, and in 32.2% (83 / 258) of those ingroup S (p = 0.51). Conclusions: No significant difference in operation time was observed when we compared the effects of thelevel of resident training in the surgical treatment of intermittent exotropia. Although the immediate postoperativeexodeviation was higher in patients who had undergone surgery assisted by a first-year resident, the surgicaloutcome during the 24-month follow-up was not significantly different.
Abstract
To evaluate the effects of the surgical assistant’s level of resident training on operation time and surgicaloutcome in the surgical treatment of intermittent exotropia. Methods: This study included 456 patients with intermittent exotropia who underwent lateral rectus recessionand medial rectus resection and were followed up for 24 months after surgery. The patients were divided intotwo groups according to the surgical assistant’s level of resident training: group F (surgery assisted by a firstyearresident [n = 198]) and group S (surgery assisted by a second-, third-, or fourth-year resident [n = 258]). The operation time and surgical outcomes (postoperative exodeviation and the number of patients who underwenta second operation) were compared between the two groups. Results: The average operation times in groups F and S were 36.54 ± 7.4 and 37.34 ± 9.94 minutes, respectively(p = 0.33). Immediate postoperative exodeviation was higher in group F (0.79 ± 3.82 prism diopters) than ingroup S (0.38 ± 3.75 prism diopters). However, repeated-measures analysis of variance revealed no significantdifference in exodeviation between the two groups during the 24-month follow-up period (p = 0.45). A secondoperation was performed in 29.3% (58 / 198) of the patients in group F, and in 32.2% (83 / 258) of those ingroup S (p = 0.51). Conclusions: No significant difference in operation time was observed when we compared the effects of thelevel of resident training in the surgical treatment of intermittent exotropia. Although the immediate postoperativeexodeviation was higher in patients who had undergone surgery assisted by a first-year resident, the surgicaloutcome during the 24-month follow-up was not significantly different.
참고문헌 (16)
- Gezer A, "Factors influencing the outcome of strabismus surgery in patients with exotropia", J AAPOS, 8, pp.56~60 (2004)[DOI]
- Lim SH, "Prognostic factors for recurrence after bilateral rectus recession procedure in patients with intermittent exotropia", Eye (Lond), 26, pp.846~852 (2012)[DOI]
- Wright KW, "Pediatric ophthalmology and strabismus", pp.306~316 (2012), Oxford University Press
- Kim YW, "The impact of incorporating of a novice assistant into a laparoscopic team on operative outcomes in laparoscopic sigmoidectomy: a prospective study", Surg Laparosc Endosc Percutan Tech, 20, pp.36~41 (2010)[DOI]
- Scheer A, "Laparoscopic colon surgery: does operative time matter?", Dis Colon Rectum, 52, pp.1746~1752 (2009)[DOI]
- Ando M, "Short operation time: an important element to reduce operative invasiveness in pediatric cardiac surgery", Ann Thorac Surg, 80, pp.631~635 (2005)[DOI]
- Mannen K, "Risk factors for complications of endoscopic submucosal dissection in gastric tumors: analysis of 478 lesions", J Gastroenterol, 45, pp.30~36 (2010)[DOI]
- Hosler MR, "Impact of resident participation in cataract surgery on operative time and cost", Ophthalmology, 119, pp.95~98 (2012)[DOI]
- Pollei TR, "Operative time and cost of resident surgical experience: effect of instituting an otolaryngology residency program", Otolaryngol Head Neck Surg, 148, pp.912~918 (2013)[DOI]
- 전강석, "사시수술 중 직근절제시 근육훅의 견인으로 인한 수술양의 오차 - 제1보", 대한안과학회지, 51(3), pp.401~405 (2010), 대한안과학회
- Winter TW, "Resident and fellow participation in strabismus surgery: effect of level of training and number of assistants on operative time and cost", Ophthalmology, 121, pp.797~801 (2014)[DOI]
- Hsu GP, "Laparoscopic Roux-en-Y gastric bypass: differences in outcome between attendings and assistants of different training backgrounds", Obes Surg, 15, pp.1104~1110 (2005)[DOI]
- Bakaeen FG, "Does the level of experience of residents affect outcomes of coronary artery bypass surgery?", Ann Thorac Surg, 87, pp.1127~1133 (2009)[DOI]
- Goodwin AT, "Effect of surgical training on outcome and hospital costs in coronary surgery", Heart, 85, pp.454~457 (2001)[DOI]
- Hwang MR, "Learning curve of assistants in laparoscopic colorectal surgery: overcoming mirror imaging", Surg Endosc, 24, pp.2575~2580 (2010)[DOI]
- 전강석, "사시수술 중 직근절제 시 근육훅의 견인으로 인한 수술량의 오차 – 제2보", 대한안과학회지, 53(5), pp.674~680 (2012), 대한안과학회[DOI]