Postoperative outcomes in oesophagectomy with trainee involvement

Επιστημονική δημοσίευση - Άρθρο Περιοδικού uoadl:3032668 108 Αναγνώσεις

Μονάδα:
Ερευνητικό υλικό ΕΚΠΑ
Τίτλος:
Postoperative outcomes in oesophagectomy with trainee involvement
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background The complexity of oesophageal surgery and the significant
risk of morbidity necessitates that oesophagectomy is predominantly
performed by a consultant surgeon, or a senior trainee under their
supervision. The aim of this study was to determine the impact of
trainee involvement in oesophagectomy on postoperative outcomes in an
international multicentre setting. Methods Data from the multicentre
Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were
analysed, which comprised prospectively collected data from patients
undergoing oesophagectomy for oesophageal cancer between April 2018 and
December 2018. Procedures were grouped by the level of trainee
involvement, and univariable and multivariable analyses were performed
to compare patient outcomes across groups. Results Of 2232
oesophagectomies from 137 centres in 41 countries, trainees were
involved in 29.1 per cent of them (n = 650), performing only the
abdominal phase in 230, only the chest and/or neck phases in 130, and
all phases in 315 procedures. For procedures with a chest anastomosis,
those with trainee involvement had similar 90-day mortality,
complication and reoperation rates to consultant-performed
oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively),
while anastomotic leak rates were significantly lower in the trainee
groups (P = 0.030). Procedures with a neck anastomosis had equivalent
complication, anastomotic leak, and reoperation rates (P = 0.150, P =
0.430, and P = 0.632, respectively) in trainee-involved versus
consultant-performed oesophagectomies, with significantly lower 90-day
mortality in the trainee groups (P = 0.005). Conclusion Trainee
involvement was not found to be associated with significantly inferior
postoperative outcomes for selected patients undergoing oesophagectomy.
The results support continued supervised trainee involvement in
oesophageal cancer surgery.
The aim of this study was to determine the impact of trainee involvement
in oesophagectomy on perioperative outcomes in the international
multicentre Oesophago-Gastric Anastomosis Audit (OGAA). Analysis of 2232
oesophagectomies has shown that trainee involvement did not negatively
impact perioperative outcomes.
Έτος δημοσίευσης:
2021
Συγγραφείς:
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Hodson, J.
Kamarajah, S. K.
Griffiths, E. A.
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Alderson, D.
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McKay, S.
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Singh, M.
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Ahmad, A.
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Yanni, F.
Couch, J.
Theophilidou,
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Reilly, J. J.
van Boxel, G.
Akbari, K.
Zanotti, D.
and Sgromo, B.
Sanders, G.
Wheatley, T.
Ariyarathenam, A.
and Reece-Smith, A.
Humphreys, L.
Choh, C.
Carter, N. and
Knight, B.
Pucher, P.
Athanasiou, A.
Tan, B. and
Abdulrahman, M.
Vickers, J.
Akhtar, K.
Chaparala, R. and
Brown, R.
Alasmar, M. M. A.
Ackroyd, R.
Patel, K. and
Tamhankar, A.
Wyman, A.
Walker, R.
Grace, B.
Abbassi, N.
and Slim, N.
Ioannidi, L.
Blackshaw, G.
Havard, T. and
Escofet, X.
Powell, A.
Owera, A.
Rashid, F.
Jambulingam,
P.
Padickakudi, J.
Ben-Younes, H.
McCormack, K.
Makey,
I. A.
Karush, M. K.
Seder, C. W.
Liptay, M. J. and
Chmielewski, G.
Rosato, E. L.
Berger, A. C.
Zheng, R. and
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Scott, C. D.
Weyant, M. J.
Mitchell,
J. D.
West Midlands Res Collaborative
Περιοδικό:
BJS OPEN
Εκδότης:
Oxford University Press
Τόμος:
5
Αριθμός / τεύχος:
6
Επίσημο URL (Εκδότης):
DOI:
10.1093/bjsopen/zrab132
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