MP58-16 RADICAL CYSTECTOMY WITH JUNIOR RESIDENTS: LONGER DAYS, EQUIVALENT OUTCOMES

Abstract

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety IV (MP58)1 Sep 2021MP58-16 RADICAL CYSTECTOMY WITH JUNIOR RESIDENTS: LONGER DAYS, EQUIVALENT OUTCOMES Joshua Linscott, Randie White, Stephen Ryan, Moritz Hansen, Jesse Sammon, and Matthew Hayn Joshua LinscottJoshua Linscott More articles by this author , Randie WhiteRandie White More articles by this author , Stephen RyanStephen Ryan More articles by this author , Moritz HansenMoritz Hansen More articles by this author , Jesse SammonJesse Sammon More articles by this author , and Matthew HaynMatthew Hayn More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002088.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical cystectomy (RC) is known to be a highly morbid, complex, and technically challenging operation. At academic centers, the assistant is traditionally a chief or senior resident. Our institution has one urology resident per year and annually performs a total of 40-50 open or robotic radical cystectomies. This leads to junior residents (PGY2, PGY3) frequently participating as the primary assistant. Here we explore the impact of resident experience level on operative, hospital, and post-operative outcomes in RC. METHODS: A single institution, prospectively maintained database identified 159 consecutive patients who underwent open or robotic RC from 2015-2019. Resident involvement was recorded in 154 cases. Operative time, estimated blood loss (EBL), intraoperative transfusion, length of stay (LOS), in hospital complication, complications in 90d, readmission at 90d, and urinary diversion complications (eg uretero-ileal stricture) were compared between junior (PGY2 & PGY3) and senior (PGY4 & PGY5) residents. Patient demographics including age, sex, BMI, neoadjuvant chemotherapy, and ASA score were examined. Statistical analysis was performed with SPSS. RESULTS: Over a 5-year period, junior residents assisted in 53 of 154 cases (34%) where a resident was involved. The number of cases done by PGY2, PGY3, PGY4, & PGY5 residents was 6, 47, 44, and 57, respectively. The percentage of open versus robotic cases was similar. There were no differences in examined patient demographics between groups. Cases with junior residents took 29.1 min (CI 3.4-54.8, p=0.027) longer than when a senior resident was present. No other significant differences between the two groups were seen when comparing EBL, intraoperative transfusion, surgical margin status, LOS, in hospital complication, 90d complication, 90d readmission, or urinary diversion complication (Table 1). CONCLUSIONS: RC remains a challenging urologic operation demanding technical excellence. Our data suggests participation by junior residents increases the length of operation by ∼10% (29.1 min) but does not negatively impact patient outcomes. We propose this is explained by increased time required for teaching and oversight from the attending surgeon, which allows junior residents to participate in a complex surgery without increasing the risk to the patient. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e994-e994 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Linscott More articles by this author Randie White More articles by this author Stephen Ryan More articles by this author Moritz Hansen More articles by this author Jesse Sammon More articles by this author Matthew Hayn More articles by this author Expand All Advertisement Loading ...