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Related Experiment Videos

Carotid endarterectomy in a general surgical training program.

R J Bloom1, C A Stevick, R Hernandez

  • 1Division of General Surgery, Veterans Administration Medical Center, Palo Alto, California 94304.

Surgery, Gynecology & Obstetrics
|October 1, 1988
PubMed
Summary

Carotid endarterectomy performed by chief surgical residents under direct attending supervision is a safe and effective training method. This practice ensures high-quality patient care without compromising outcomes for vascular disease treatment.

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Area of Science:

  • Vascular Surgery
  • Surgical Education
  • Patient Safety

Background:

  • Concerns exist regarding surgical training quality and attending surgeon involvement.
  • Vascular surgical fellowships aim to specialize training in vascular disease diagnosis and treatment.
  • The role of general surgical residents versus fellows in carotid endarterectomies is debated.

Purpose of the Study:

  • To evaluate the safety and effectiveness of carotid endarterectomy performed by chief general surgical residents under direct supervision.
  • To examine the quality of patient care during resident-led carotid reconstructions.

Main Methods:

  • Retrospective review of 153 carotid endarterectomies and reconstructions performed between April 1980 and July 1984.
  • Analysis of patient records for indications, procedures performed by residents, and postoperative outcomes.

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  • Ninety-three percent of procedures were conducted by chief general surgical residents under attending surgeon supervision.

    • Main Results:

    • The study included 129 patients with 153 carotid artery reconstructions.
    • Indications included symptomatic (96) and asymptomatic (57) carotid atheromatous disease.
    • Postoperative rates for cardiovascular deficits, cranial nerve deficits, and central neurologic deficits were 1.3% each, with no operative mortality.

    Conclusions:

    • Carotid endarterectomy under close supervision offers a safe and effective learning experience for surgical residents.
    • This training approach allows residents to develop skills in precise dissection and arterial repair.
    • High standards of patient care are maintained, supporting the practice as a valuable educational tool.