• Lapo Bencini, Marco Bernini, Francesco Martini, Michele Rossi, Cinzia Tommasi, Egidio Miranda, Luis Josè Sanchez, Riccardo Naspetti, Roberto Manetti, Angelo Ferrara, Silvia Nesi, Bernardo Boffi, Marco Farsi, and Renato Moretti.
• Department of Oncology, Careggi Main Florence University and Regional Hospital, Italy. lapbenc@tin.it
• JSLS. 2009 Jul 1; 13 (3): 391-7.

BackgroundLaparoscopic appendectomy is widely performed by surgical residents, but its changing indications and outcomes have been poorly investigated. The aim of this study was to examine whether a difference exists in indications and outcomes between laparoscopic appendectomies performed by residents and those performed by experienced surgeons.MethodsBetween 1999 and 2007, 218 laparoscopic appendectomies were performed and recorded. Data were analyzed to compare operations performed by residents with those by experienced surgeons in terms of indications for surgery and severity of disease. Moreover, laparoscopic appendectomies were thoroughly compared regarding outcomes and complications.ResultsThe residents had fewer conversions with laparoscopic appendectomy (8% vs 17%, P=0.04), and similar complication rates (12% vs 13%, P=0.16), compared with experienced surgeons. The median operating time was also comparable (67 minutes vs 60 minutes, P=0.23). However, patients operated on by residents had more emergencies (86% vs 70%, P=0.009), included more foreigners (27% vs 15%, P=0.03), and had intermediate to severe diseases, (81 vs 52%, P<0.001) than patients did operated on by experienced surgeons.ConclusionsSurgical residents performed more emergency laparoscopic appendectomies on foreign patients suffering from intermediate to severe diseases compared with experienced surgeons, with comparable surgical outcomes and lower conversion rates.

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