General Surgical Operative Duration Is Associated with Increased Risk-Adjusted Infectious Complication Rates and Length of Hospital Stay

Procter, Levi; Davenport, Daniel L.; Bernard, Andrew C.; Zwischenberger, Joseph B.

doi:10.1016/j.jamcollsurg.2009.09.034

Cited by 307 publications

(171 citation statements)

References 23 publications

Supporting

Mentioning

156

Contrasting

Unclassified

Order By: Relevance

“…This is frequently associated with the reportedly steep learning curve that comes with robotic surgery as a consequence of its distinct instrumentation and technique (5,9,10). These are valid considerations, as longer operative durations have been shown to independently increase potential for infectious complications and length of hospital stay (11). Compounding this, cost estimations peg an additional minute of operating room time between $22 and $133 in the United States (12).…”

Section: Introductionmentioning

confidence: 99%

Tips and tricks to decrease the duration of operation in robotic surgery for lung cancer

2017

View full text Add to dashboard Cite

Minimally invasive surgery (MIS) for lung cancer has been associated with decreased perioperative morbidity while maintaining similar long-term survival when compared to open thoracotomy.Robotic thoracic surgery constitutes an evolutionary step in this field, beckoning dramatic advancements both in visualization as well as surgical instrument range of motion and ergonomics. As such, robotic thoracic surgery is growing in adoption worldwide. One of its oft-cited disadvantages, however, is increased operative time, especially for less-experienced surgeons. We describe an assortment of tips and tricks that we conclude can safely reduce robotic operative duration.

show abstract

Section: Introductionmentioning

confidence: 99%

Tips and tricks to decrease the duration of operation in robotic surgery for lung cancer

2017

View full text Add to dashboard Cite

show abstract

“…Moreover, the operative time gradually decreased with the accumulation of surgical experience in robotic gastrectomy. Nonetheless, longer operative time is regarded as the main drawback of robotic gastrectomy, because it may affect patient recovery, especially in those with comorbidity 32, 33, 34…”

Section: Perioperative Outcomesmentioning

confidence: 99%

Robotic gastrectomy for gastric cancer: Current evidence

Alhossaini

Altamran

Seo

et al. 2017

Annals of Gastroent Surgery

View full text Add to dashboard Cite

The robotic system has gained wide acceptance in specialties such as urological and gynecological surgery. It has also been applied in the field of upper gastrointestinal surgery. Since the first implementation of the robotic system for the treatment of gastric adenocarcinoma, the procedure has been found to be safe and feasible. Although robotic gastrectomy does not meet our expectations and yield better results than laparoscopic gastrectomy, this procedure seems to provide several advantages over laparoscopy such as reduced blood loss, shorter learning curves and increased number of retrieved lymph nodes. However, as many case series, including a recent multicenter study, have revealed, higher cost and longer operation time are the major limitations of robotic gastrectomy. Furthermore, there are no results from well‐designed randomized clinical trials comparing the two procedures. New procedures in much more technically demanding cases will test the genuine benefits of robotic gastrectomy.

show abstract

“…In numerous studies, operative time has been recognized as a risk factor for adverse surgical outcomes. 4,16,32,33,36,37,42,43,45 Neurosurgery studies indicate that increased operative time is a significant risk factor for infections and cranial nerve injury following craniotomy and carotid endarterectomy, respectively. 11,13,22,25 Thus, the differences in operative time between the two cohorts may explain some of the increase in complication rates with resident involvement prior to baseline adjustment.…”

Section: Multivariate Analyses and Confounding Factorsmentioning

confidence: 99%

Impact of resident involvement in neurosurgery: an analysis of 8748 patients from the 2011 American College of Surgeons National Surgical Quality Improvement Program database

Lim

Parsa²,

Kim

et al. 2015

JNS

View full text Add to dashboard Cite

OBJECT This study evaluates the impact of resident presence in the operating room on postoperative outcomes in neurosurgery. METHODS The authors retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and identified all cases treated in a neurosurgery service in 2011. Propensity scoring analysis and multiple logistic regression models were used to reduce patient bias and to assess independent effect of resident involvement. RESULTS Of the 8748 neurosurgery cases identified, residents were present in 4529 cases. Residents were more likely to be involved in complex procedures with longer operative duration. The multivariate analysis found that resident involvement was not a statistically significant factor for overall complications (OR 1.116, 95% CI 0.961–1.297), surgical complications (OR 1.132, 95% CI 0.825–1.554), medical complications (OR 1.146, 95% CI 0.979–1.343), reoperation (OR 1.250, 95% CI 0.984–1.589), mortality (OR 1.164, 95% CI 0.780–1.737), or unplanned readmission (OR 1.148, 95% CI 0.946–1.393). CONCLUSIONS In this multicenter study, the authors demonstrated that resident involvement in the operating room was not a significant factor for postoperative complications in neurosurgery service. This analysis also showed that much of the observed difference in postoperative complication rates was attributable to other confounding factors. This is a quality indicator for resident trainees and current medical education. Maintaining high standards in postgraduate training is imperative in enhancing patient care and reducing postoperative complications.

show abstract

General Surgical Operative Duration Is Associated with Increased Risk-Adjusted Infectious Complication Rates and Length of Hospital Stay

Cited by 307 publications

References 23 publications

Tips and tricks to decrease the duration of operation in robotic surgery for lung cancer

Tips and tricks to decrease the duration of operation in robotic surgery for lung cancer

Robotic gastrectomy for gastric cancer: Current evidence

Impact of resident involvement in neurosurgery: an analysis of 8748 patients from the 2011 American College of Surgeons National Surgical Quality Improvement Program database

Contact Info

Product

Resources

About