Teaching residents in emergency surgery for acute bowel obstruction—is supervised surgery safe and feasible? A retrospective single-center analysis from a MIS-specialized hospital

Abstract

Objective Emergency surgery for acute bowel obstruction (ABO) is a common and occasionally technically demanding procedure, requiring both surgical skill and strategic planning. The risk entailed in teaching residents during ABO surgery has not been defined or investigated in detail to date. It is the aim of this study to reveal whether surgery for ABO, performed by resident surgeons under supervision, is safe and feasible. Design A retrospective analysis was conducted of all emergency surgeries for ABO performed between 2009 and 2023 at a community-based hospital. Patients’ general characteristics, procedural data and outcome parameters were compared. Differences between teaching procedures and non-teaching procedures were analysed. Setting The study was conducted at the Department of General and Visceral surgery at a community-based hospital (St. John of God Hospital Salzburg, Austria). Participants All emergency surgeries for ABO (n = 300 patients) that were performed during the study period were included. Results Emergency surgery for ABO was performed in 300 patients during the study period, 15.3% of which operations were performed by residents under supervision and 84.7% by senior surgeons. No differences between these two groups were found in terms of patient characteristics, except for a past medical history of previous gynecologic or urologic surgery that was more frequent in the senior surgeon group (p = 0.02). Neither procedural data nor conversion rates from a minimally invasive (MIS) to an open (OS) approach, nor postoperative complication rates were found to be significantly different between these groups. Conclusion Emergency surgery for ABO, performed by residents under supervision, is safe and feasible, showing no significant differences in terms of complication rates, morbidity or mortality as compared to procedures performed by senior surgeons. Graphical abstract