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Two Surgeons Are Faster than One: A Comparative Study to Evaluate Efficiency and Outcomes in Reduction Mammaplasty
Iselin Saltvig1, Salvatore Giordano2,3
1Department of Plastic and General Surgery, Turku University Hospital, and the University of Turku, Turku, Finland.
Background:
The increasing demand for reduction mammaplasty has heightened the need for cost-effective and efficient surgical practices. Evidence from other surgical fields suggests that co-surgeon teams can improve operative efficiency.
Aims And Objectives:
This study aimed to compare operative time and outcomes in reduction mammaplasty performed by co-surgeons (CS) versus a single surgeon (SS).
Materials And Methods:
We conducted a retrospective cohort study including all consecutive patients who underwent primary reduction mammaplasty in a 20-years period. All procedures were led by attending faculty surgeons, with assistants being either residents or other attendings. The primary outcome was operative time; secondary outcomes included intraoperative blood loss; resection weight, postoperative complications, reoperations, and length of hospital stay.
Results:
A total of 1716 patients were included: 855 (49.8%) underwent surgery with a SS, and 861 (50.2%) with a CS. Demographic and comorbidity profiles were mostly similar across the groups. Operative time was significantly shorter in the CS group (119.6 vs. 136.1 minutes, p < 0.001). Postoperative complication rates and early reoperations were similar between groups. However, CS cases had a longer mean hospital stay (0.6 vs. 0.4 days, p < 0.001). Late reoperations (>30 days post-op), particularly for dog-ear corrections were more common in the CS group (11.7 vs. 3.0%, p < 0.001). Multivariate analysis showed that higher BMI and smoking were significant predictors of complication occurrence.
Conclusion:
Using co-surgeons in reduction mammaplasty significantly reduces operative time. However, it may be associated with longer hospital stay and increased long-term reoperation rates. Further studies are needed to evaluate the cost-benefit ratio of this approach.
Level Of Evidence Iii:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
