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Vol. 100. Issue 4.
Pages 223-228 (April 2022)
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Vol. 100. Issue 4.
Pages 223-228 (April 2022)
Original article
Sleep deprivation among surgical residents: Does it affect performance while practising a laparoscopic intestinal anastomosis?
Fatiga por deprivación de sueño en residentes de cirugía: ¿Afecta a los resultados al realizar una anastomosis laparoscópica intestinal?
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Héctor Real Novala,
Corresponding author
hectorrealnoval@hotmail.com

Corresponding author.
, José Ignacio Martin Parrab,c, Jennifer Fernández Fernándezd, Álvaro del Castillo Criadoe, José Luis Ruiz Gómezc,f, Antonio López Userosb,c, Roberto Fernández Santiagob,c, José Carlos Manuel Palazuelosb,c
a Servicio de Cirugía General, Hopistal de Jarrio, Coaña, Asturias, Spain
b Servicio de Cirugía General, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
c Hospital virtual Valdecilla, Santander, Cantabria, Spain
d Servicio de Neurología, Hospital San Agustín, Avilés, Asturias, Spain
e Servicio de Cirugía General, Hospital Virgen de la Concha, Zamora, Castilla y León, Spain
f Servicio de Cirugía General, Hospital Sierrallana, Torrelavega, Cantabria, Spain
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Tables (3)
Table 1. Univariate comparison between the two groups.
Table 2. Variables of the logistic regression equation.
Table 3. Results of the anastomotic leak variable depending on the years of residency.
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Abstract
Introduction

To assess the impact of fatigue due to incorrect night rest in the performance of a laparoscopic manual anastomosis.

Methods

A prospective study evaluating the results from the realization of a manual endotrainer entero-enteral anastomosis performed by residents in terms of fatigue caused by inadequate nightly rest. Two groups were established; the FATIGUE group (F): anastomosis performed by residents coming off shift who slept less than seven hours and the REST group(R), being those who slept at home for more than 7 h. The time taken, length of the anastomosis and quality of such were compared based on 4 parameters: Air leak test, correct tension on the suture line, accurate opposition of the edges and optimal distance between stitches.

Results

402 anastomoses were studied (211 rest group, 191 fatigue group). In the fatigue group leaks were detected in 33.5% anastomoses, as opposed to 19.4% in the rest group (P < .01). El rest group performed the anastomosis in 56.75 min and the fatigue group in 61,49 min (P = .006). There were no significant differences in the others parameters.

Conclusions

Fatigue increases the risk of leakage and the time to do the exercise.

Keywords:
Sleep deprivation
Laparoscopic surgical skills training
Resident training
Fatigue
Resumen
Introducción

Evaluar el impacto de la fatiga por incorrecto descanso nocturno en la realización de una anastomosis manual laparoscópica.

Métodos

Se lleva a cabo un estudio prospectivo observacional evaluando la realización de una anastomosis manual enteroenteral en endotrainer por residentes. Se dividen en dos grupos; el grupo descanso incluye a residentes que han dormido en casa 7 o más horas frente al grupo fatiga formado por residentes de guardia o que han dormido menos de 7 horas. Se evalúa el tiempo empleado, la longitud de la anastomosis, la correcta tensión de la línea de sutura, la correcta aposición de los bordes, la distancia entre puntos y la fuga de aire en prueba neumática de estanqueidad.

Resultados

Se evalúan 402 anastomosis, siendo 211 pertenecientes al grupo descanso y 191 al grupo fatiga. Se detecta fuga en el 33,5% de las anastomosis del grupo fatiga frente al 19,% en el grupo descanso (p < 0,01). El tiempo empleado en el grupo descanso es de 56,75 min. frente a 61,49 en el grupo fatiga (p = 0,006). No hay diferencias en el resto de parámetros.

Discusión

La fatiga aumenta el riesgo de fuga y el tiempo que se tarda en completar el ejercicio.

Palabras clave:
Deprivación de sueño
Entrenamiento en habilidades quirúrgicas laparoscópicas
Entrenamiento residente
Fatiga

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