Early Outcomes of Surgery for Oesophageal Cancer in a Thoracic Regional Unit. Can We Maintain Training Without Compromising Results?

Overview

Journal Eur J Cardiothorac Surg

Publisher Oxford University Press

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2011 May 31

PMID 21622004

Citations 4

Authors

Sumana D M Handagala

Emmanuel Addae-Boateng

David Beggs

John P Duffy

Antonio E Martin-Ucar

Affiliations

Soon will be listed here.

Abstract

Objectives: Meaningful exposure to oesophageal cancer surgery during general thoracic surgical training is restricted to few centres in the United Kingdom. Our Regional Tertiary Unit remains a rare 'large-volume' oesophagectomy centre. We aimed to determine the proportion of patients operated by trainees and their perioperative outcomes.

Methods: From January 2004 to September 2009, 323 patients (229 male and 94 female, median age of 69 (range 40-92) years) underwent oesophagectomy for carcinoma in our Thoracic Surgical Unit. Data were complete and obtained from a prospective departmental database. The preoperative characteristics, operative data and postoperative results were compared between the 120 patients (37%) operated by a trainee (group T) and the remainder 203 patients operated by a consultant (group C).

Results: The overall incidence of mortality, anastomotic leak and chylothorax were 6.5%, 5.3% and 2.2%, respectively. There were no differences in terms of age, gender, tumour location, tumour staging, preoperative spirometry or use of neoadjuvant chemotherapy between the two groups. There was no significant difference between the consultant group and the trainee group in the following key outcome measures: postoperative mortality (8% vs 4%), incidence of respiratory complications (30% vs 25%), hospital stay (14 days vs 13 days) and number of lymph nodes excised (median of 16 vs 14).

Conclusions: Training in oesophageal cancer surgery can be provided in a large-volume thoracic surgical unit. It does not seem to compromise outcomes or use of resources.

Citing Articles

Postoperative outcomes in oesophagectomy with trainee involvement.

BJS Open. 2022; 5(6).

PMID: 35038327 PMC: 8763367. DOI: 10.1093/bjsopen/zrab132.

Registrar performance in minimally invasive distal pancreatectomy and effects on postoperative outcomes.

Souche R, Ferrandis C, Gautier A, Guillon F, Bardol T, Fabre J Langenbecks Arch Surg. 2021; 406(7):2357-2365.

PMID: 34036406 DOI: 10.1007/s00423-021-02212-x.

Trainee performance in radical gastrectomy and its effect on outcomes.

Navidi M, Madhavan A, Griffin S, Prasad P, Immanuel A, Hayes N BJS Open. 2020; 4(1):86-90.

PMID: 32011816 PMC: 6996638. DOI: 10.1002/bjs5.50219.

Completely Linear Stapled Versus Handsewn Cervical Esophagogastric Anastomosis After Esophagectomy.

Kumar T, Krishanappa R, Pai E, Sringeri R, Singh T, Swain J Indian J Surg. 2018; 80(2):134-139.

PMID: 29915479 PMC: 5991018. DOI: 10.1007/s12262-018-1732-5.

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