Background : The availability of assistive surgical personnel plays a crucial role in optimizing patient outcomes and operational efficiency. South Korea experienced a significant shift in surgical practices due to a nationwide resident strike, necessitating single-surgeon procedures in most hospitals. This study examines the impact of this transition on surgical outcomes.

Methods : This study used prospectively collected surgical records at CHA Bundang Medical Center. Patients who underwent surgery between August 2023 and September 2024 were divided into two groups consecutively (Group 1: August 2023 to February 2024, surgeries performed with an assistant doctor vs. Group 2: March 2024 to September 2024, single-surgeon surgeries). Surgical outcomes and prognostic factors were analyzed between two groups.

Results : A total of 995 surgeries were analyzed, with 499 in Group 1 and 496 in Group 2. Compared to Group 1, Group 2 had a higher complication rate (3.8% vs. 7.5%, p= 0.018) and longer mean hospital stays (4.9 ± 5.2 vs 6.0 ± 6., p = 0.004). In the prognostic factor analysis associated with major complications, single-surgeon surgery (crude OR: 2.6, p = 0.012), major operation (crude OR: 14.18, p < 0.001), and organ type (OR: pancreas: 26.87, p < 0.001) were identified as statistically significant in univariate analysis. However, in the multivariate analysis, only single-surgeon surgery (OR: 2.26, p = 0.054) and organ type (OR: pancreas: 23.37, p < 0.001) remained statistically significant.

Conclusions : Single-surgeon surgeries, necessitated by the absence of resident workforce, were associated with a higher complication rate and longer hospital stays.