• Christian P Meyer, Julian Hanske, David F Friedlander, Marianne Schmid, Roland Dahlem, Vincent Q Trinh, Steven L Chang, Adam S Kibel, Felix K H Chun, Margit Fisch, Quoc-Dien Trinh, and Jairam R Eswara.
• Division of Urologic Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: christian.p.meyer@gmail.com.
• Urology. 2015 Apr 1; 85 (4): 937-41.

ObjectiveTo assess the effect of resident involvement in male anterior urethroplasties with regard to perioperative and postoperative outcomes using a large multi-institutional prospectively collected database.MethodsRelying on the American College of Surgeons National Surgical Quality Improvement Program Participant User Files (2005-2012), we extracted all entries with Current Procedural Terminology coding for male one-stage anterior urethroplasty in men (54,310). Cases with missing entries on resident involvement were excluded. Descriptive and logistic regression analyses were constructed to assess the impact of trainee involvement (attending only vs resident) on perioperative and postoperative outcomes. Prolonged operative time (pOT) was defined as operative time >75th percentile (>204 minutes).ResultsA total of 235 one-stage urethroplasties were performed during the study period, for which resident involvement was available. Resident involvement was significantly associated with younger patient age (P = .011) and patients with a pre-existing diabetic condition (P = .047). In univariate analyses, the rate of pOT was significantly higher in the resident involvement group (P = .027). In multivariate models, resident involvement was an independent predictor of pOT (odds ratio, 2.4; 95% confidence interval, 1.3-9.7; P = .035). There were no differences in 30-day postoperative complications, length of hospital stay, or readmissions. Limitations of the study include inability to adjust for case complexity and type of reconstruction.ConclusionResident involvement is associated with pOT for anterior urethral strictures. However, it does not adversely affect complication rates or the length of hospital stay.Copyright © 2015 Elsevier Inc. All rights reserved.

21 keywords...

hide…