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Vascular Surgery Procedures Performed By Residents. A Narrative Review On The Impact In 30-Day Outcomes.
Tiago Ribeiro1, Rita Soares Ferreira2, Rita Bento3
1Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central; Lisboa, Portugal.
Summary
Resident surgeons performing common vascular procedures like carotid endarterectomy and arteriovenous fistulas generally achieve outcomes comparable to experienced surgeons, with some procedures taking longer. Further research is needed to fully understand resident involvement in complex vascular surgeries.
Area of Science:
- Vascular Surgery
- Surgical Education
- Patient Outcomes
Background:
- Increasing scrutiny of surgical outcomes supports centralization of care in teaching hospitals.
- Surgical residents train in technical skills, often participating as primary operators.
- Evidence on the impact of trainee-performed procedures on patient outcomes is limited.
Purpose of the Study:
- To investigate the outcomes of common vascular procedures performed by surgical residents.
- To assess the impact of trainee involvement on patient safety and procedure success.
Main Methods:
- A non-systematic literature review of MEDLINE and Scopus databases.
- Focused on outcomes of resident-performed common vascular procedures.
Main Results:
- Limited evidence exists for procedures like venous disease, aortic aneurysms, and peripheral artery disease.
- Resident-performed carotid endarterectomy (CEA) showed similar rates of stroke and cranial nerve palsy compared to experts.
- Resident-performed arteriovenous fistulas (AVF) demonstrated comparable patency but longer procedure times.
- Resident involvement in aortic aneurysm repair did not appear to increase adverse events.
Conclusions:
- The impact of resident performance on outcomes in most vascular surgery is not well-defined.
- Resident-performed CEA and primary AVF appear safe for patients.
- Further research is necessary to fully elucidate outcomes associated with resident-performed vascular procedures.
