The reduction in benign gastric ulcer disease may mean that surgery residents now have insufficient gastric surgery experience.
In this study, a team from Chicago, Illinois, analyzed resident-reported gastric procedure experience by chief residents from US programs between 1990 and 2001.
The team found that for all gastric-related surgery, the average cases per chief resident ranged from 9.8 to 12.4 with a peak in 1990 and a nadir in 1999. They found that the case average in 2001 was 11.3.
|The percentage of all types of gastric resections decreased.|
|Journal of Gastrointestinal Surgery|
During the same period, the team determined that vagotomy decreased from 24% in 1990 to 7% in 2001.
However, gastric-reduction operations increased from 5% to 34%.
Furthermore, total gastrectomy remained constant at <1 per chief resident, whereas partial gastric resection (PGR) was unchanged.
Overall the investigators found that the percentage of all types of gastric resections decreased from 34% in 1990 to 29% in 2001.
Dr Joseph Espat's team concluded, "US surgical chief residents report a widely variable experience in gastric surgery over the period analyzed".
"However, their overall experience has not significantly diminished since 1990 although specific procedural volume has varied".