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Impact of Trainee Involvement in Cervical Excision Procedures: Does Trainee Involvement Impact Quality?
Stephanie A Sullivan1, Leslie H Clark1, Lindsay M West1
1Division of Gynecologic Oncology, University of North Carolina, Chapel Hill, NC.
Journal of Lower Genital Tract Disease
|December 23, 2017
Summary
Trainee involvement in cervical excision procedures does not impact specimen margin status. However, procedures with trainees showed a greater specimen depth, though this was not statistically significant after adjustments.
Area of Science:
- Gynecologic Oncology
- Surgical Education
- Pathology
Background:
- Cervical excision procedures are critical for treating cervical dysplasia and malignancy.
- Assessing the impact of trainee involvement on surgical specimen quality is essential for patient care standards.
Purpose of the Study:
- To evaluate if trainee participation in cervical excision procedures influences the quality of the resulting excision specimen.
- To determine the effect of resident physician involvement on margin status and specimen dimensions.
Main Methods:
- Retrospective cohort study of 94 cervical cancer patients (2000-2015).
- Included loop electrosurgical excision or cold knife cone procedures with available pathology.
- Primary outcome: margin status; Secondary outcomes: specimen width and depth. Trainee participation was the exposure of interest.
Main Results:
- 58% of procedures involved trainee participation.
- No significant differences in margin status (77% vs 78%) or specimen width between trainee and non-trainee cases.
- A statistically significant difference in median specimen depth was observed (15.4 mm with trainees vs 12 mm without, p < .02).
- After adjustment, only indication and excision type, not trainee presence, were associated with greater depth.
Conclusions:
- Trainee involvement in cervical excision procedures does not negatively affect the quality of the excision specimen.
- While specimen depth was greater with trainee involvement, this finding was not independently associated with trainee presence upon further analysis.
