Can Ileostomy Reversal Be Safely Performed by Surgical Residents?

Area of Science:

• Colorectal Surgery
• Surgical Education
• Patient Safety

Background:

• Increasing colorectal cancer incidence necessitates robust surgical training.
• Polish surgical training program changes require more intestinal procedures for residents.
• Assessing resident-performed ileostomy reversals is crucial for surgical education.

Purpose of the Study:

• To evaluate the safety and feasibility of ileostomy reversal procedures conducted by surgical residents.
• To compare resident-performed ileostomy reversals with those done by specialist surgeons.

Main Methods:

• A multicenter prospective cohort study (LILEO study) involving 199 patients undergoing ileostomy reversal.
• Patients were divided into two groups: 139 operated by specialists and 60 by residents.
• Primary outcomes included complications, length of stay, and reoperation rates; secondary outcomes assessed complication severity (Clavien-Dindo).

Main Results:

• Shorter median length of hospital stay in the resident group (5.5 days vs. 6 days, p < 0.05).
• Overall complication rates were similar (21.7% residents vs. 33.1% specialists, p=0.105).
• Minor complications were more frequent in the specialist group; no significant differences in loop ileostomy reversals.

Conclusions:

• Supervised ileostomy reversals by surgical residents are safe and feasible.
• Outcomes are comparable to those performed by specialist surgeons.
• Ileostomy reversals are valuable for resident skill development without adverse patient outcomes.