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Differences in Outcomes and Histopathological Diagnostic Accuracy Between Trainees and Consultants in Appendicectomies: A Single Centre Experience
Poster
Talk Description

Institution: South Western Sydney Local Health District - NSW, Australia

Purpose Laparoscopic appendicectomy is a recognised important starting point for trainees to obtain laparoscopic skill sets.1 Reviewing and identifying outcome differences between consultant and trainees remains important in order to ensure quality emergency surgical care is not compromised by our obligation to surgical training. Methodology This analysis aims to compare outcome measures of emergency appendicectomies across all severities, between trainees and consultants with outcome measures being operative time, accuracy of diagnosis and length of stay (LOS). The accuracy of diagnosis is measured by comparing intraoperative diagnosis with the gold standard of the pathological diagnosis from the subsequent histopathology report. Results Trainees demonstrated shorter mean operation times (62.5 minutes vs 69.3 minutes) for all patients, excluding those with perforated or necrotic appendicitis (p<0.01). LOS was shorter in the trainee group across all operations (2.2 vs 3.5 days, p<0.01), and this was consistent with mild and suppurative appendicitis. Otherwise, operation time & LOS did not significantly vary by operator rank (p<0.01). Trainees did not demonstrate an increase in post-operative complications for all severities of appendicitis. Histological accuracy was higher in the trainee group, at 61% vs 53% (p<0.01). This was particularly significant when identifying suppurative appendicitis. Conclusion Overall, regardless of the severity of the appendicitis, appendicectomies performed by trainees did not result in any increase in operation time, postoperative complications nor LOS when compared with consultants. Trainees also have demonstrated comparable accuracy with identifying appendix appearance compared with consultants. References 1. Sweeney KJ, Dillon M, Johnston SM, Keane FB, Conlon KC. Training in laparoscopic appendectomy. World J Surg. 2006 Mar;30(3):358-63.
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Dr Azra Tabassum - , Dr Phelopatir Anthony - , Dr Tahmina Hakim - , Mr Peter Morian - , Dr Selwyn Selvendran - , Prof Neil Merrett - , Dr Edward Tong -

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