Page 23 - Delaware Medical Journal - May/June 2019
P. 23
CASE REPORT
TABLE 4: Concomitant procedures, curve correction, blood loss, procedure time, postoperative hospital course, and complications within 90 days of surgery for procedures in which a fellow or resident assisted with and without the involvement of a second surgical assistant
Leading surgeon + fellow/resident
5 patients
Leading surgeon + fellow/resident + 2nd assistant
23 patients
Number
%
Number
%
P values
Anterior release
1
20
0
0
0.029
ITB implantation
0
0
2
9
0.494
ITB catheter replacement
2
40
4
17
0.264
Hip plate removal
2
40
1
4
0.019
Partial coccygectomy
0
0
0
0
>0.99
Mean
SD
Mean
SD
P values
Curve correction (%)
-68
15
-75
11
0.394
Blood loss (mL)
3600
1022
3143
1460
0.429
Procedure time (minutes)
296
36
287
44
0.629
Intubation (days)
2
2
3
3
0.418
ICU stay (days)
11
14
7
6
0.523
Hospital stay (days)
14
8
13
9
0.895
Number
%
Number
%
P values
Complications
1
20
1
4
0.218
analysis. However, the study reports
by a single leading surgeon with lengthy experience in performing this procedure and in teaching different levels of surgical assistants. Therefore, the groups were considered comparable, with the assistant’s level being the only different variable.
This study emphasizes the safety of surgical education in scoliosis surgery
in patients with cerebral palsy. However, having more experienced assistants who have an interest in the procedure as part of their future career in management of neuromuscular disorders, has mutual experience level of leading surgeons, including experience in teaching assistants, in the operating room is an important factor for evaluation whenever surgery are planned.
Compliance with Ethical Standards Funding: None
of Interest: All authors declare
Ethical Approval: This study was approved by our Institutional Review Board. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Ethical Approval: This article does not contain any studies with animals performed by any of the authors.
Informed Consent: Informed consent was not required in this retrospective review.
ICU: intensive care unit, ITB: intrathecal baclofen, SD: standard deviation
CONTRIBUTING AUTHORS
■ OUSSAMA ABOUSAMRA, MD is a former research fellow at Nemours/Alfred I. duPont Hospital for Children in Wilmington. He is currently an attending physician and Assistant Professor of Clinical Orthopaedic Surgery at Keck School of Medicine of USC in Los Angeles, California.
■ MARIA DEL PILAR DUQUE OROZCO, MD is a former research fellow at Nemours/Alfred I. duPont Hospital for Children. She is currently a pediatric orthopaedic surgeon in Medellin, Colombia.
■ KENNETH J. ROGERS, PHD, ATC is the Program Manager for Clinical Research with the Department of Orthopaedics at Nemours/Alfred I. duPont Hospital for Children. He has published and presented on orthopaedic topics for the last 35 years.
■ FREEMAN MILLER, MD is a Pediatric Orthopaedic surgeon at Nemours/Alfred I. duPont Hospital for Children. His sub-specialty is cerebral palsy.
■ JULIEANNE P. SEES, DO is a pediatric orthopaedic surgeon at Nemours/Alfred I. duPont Hospital for Children. Her sub-specialty is cerebral palsy.
Del Med J | May/June 2019 | Vol. 91 |
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