Laparoscopic elective colorectal procedures performed by supervised residents are safe and sufficient – a retrospective propensity-score-matched cohort study.

INTRODUCTION: Laparoscopic colorectal surgery (LCS) is a valuable method of colorectal cancer treatment and an integral component of residency training programs in general surgery. Real participation of residents in LCS, their outcomes, and proficiency thresholds in basic laparoscopy procedures for performing high-quality LCS remain unclear.

Aim

This study aimed to comprehensively assess the outcomes of LCS performed by supervised general surgery residents and evaluate their prior laparoscopic experience.MATERIAL AND

Methods

A retrospective single-center analysis included elective LCS for colorectal cancer performed by colorectal surgeons and supervised residents. The quality measures and outcomes were compared between the groups with the propensity score matching analysis (PSM) and an assessment of the resident's previous experience in laparoscopic techniques.

Results

The analysis included 412 elective LCS: 42 performed by residents (Group 1), and 370 by experts (Group 2). The patient groups were equal in demographics and cancer staging. Procedures performed by residents were significantly longer (154 vs. 125 minutes; p<0.05). There was no significant difference regarding surgical complications and mortality. PSM analysis confirmed prolonger time (154 vs 136 minutes, p<0.05) and indicated a higher number of resected lymph nodes in residents’ group (16 vs 13; p<0.05). The resident had performed over 80 laparoscopic procedures for other indications and had assisted in an average of 24 LCSs.

Conclusions

Elective LCS procedures performed by residents under supervision are both safe and effective, ensuring high-quality indicators of oncological care. Introducing LCS training in the early years of residency may enable proficiency to be achieved at an earlier stage of a physician’s career.