Does resident involvement in tonsillectomy affect outcomes?

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Surgical Education

Background:

• Tonsillectomy is a common pediatric surgical procedure with known complication risks.
• Evaluating surgical resident performance is crucial for training and patient safety.
• Post-tonsillectomy bleeding is a significant concern, necessitating careful monitoring.

Purpose of the Study:

• To assess the impact of resident surgeon involvement on post-tonsillectomy complications in children.
• To compare complication rates, specifically bleeding, between surgeries performed by attending surgeons and those supervised by pediatric otolaryngologists.
• To determine if resident involvement influences emergency room (ER) visits or other adverse events.

Main Methods:

• A retrospective chart review was conducted for children aged 12 and under undergoing tonsillectomy +/- adenoidectomy between January 2019 and December 2020.
• Data collected included patient demographics, surgical technique, resident involvement, and postoperative bleeding events (primary and secondary).
• Binary logistic regression analysis was used to identify predictors of postoperative ER visits and bleeding.

Main Results:

• The study included 2051 children; 32.2% had a resident surgeon involved.
• Postoperative ER visits occurred in 13.4% of patients, with resident involvement being a significant predictor of decreased ER utilization (OR=0.585).
• Patient age was a significant predictor for overall and secondary postoperative bleeding, but resident involvement did not significantly increase bleeding risk.

Conclusions:

• Resident involvement in pediatric tonsillectomy is associated with a reduction in postoperative emergency room visits.
• The presence of a resident surgeon does not appear to elevate the risk of common complications like post-tonsillectomy bleeding or dehydration.
• Supervised resident participation in tonsillectomy is a safe practice that may improve healthcare resource utilization.