Postoperative outcomes in oesophagectomy with trainee involvement

被引：2

作者：

Evans, R. P. T. ^{[1
]}

Hodson, J. ^{[1
]}

Kamarajah, S. K. ^{[1
]}

Griffiths, E. A. ^{[1
]}

Singh, P. ^{[1
,110
]}

Alderson, D. ^{[1
]}

Bundred, J. ^{[1
]}

Gossage, J. ^{[1
,100
]}

Jefferies, B. ^{[1
]}

McKay, S. ^{[1
,101
]}

Mohamed, I ^{[1
,114
]}

Nepogodiev, D. ^{[1
]}

Siaw-Acheampong, K. ^{[1
]}

van Hillegersberg, R. ^{[1
,47
]}

Vohra, R. ^{[1
,110
]}

Wanigasooriya, K. ^{[1
]}

Whitehouse, T. ^{[1
]}

Gjata, A. ^{[1
]}

Moreno, J., I

Takeda, F. R.

Kidane, B.

Castro, R. Guevara

Harustiak, T.

Bekele, A.

Kechagias, A.

Gockel, I

Kennedy, A.

Da Roit, A.

Bagajevas, A.

Azagra, J. S.

Mahendran, H. A.

Mejia-Fernandez, L.

Wijnhoven, B. P. L.

El Kafsi, J.

Sayyed, R. H.

Sousa, M.

Sampaio, A. S.

Negoi, I

Blanco, R.

Wallner, B.

Schneider, P. M.

Hsu, P. K.

Isik, A.

Gananadha, S. ^{[2
]}

Wills, V ^{[3
]}

Devadas, M. ^{[4
]}

Duong, C. ^{[5
]}

Talbot, M. ^{[6
]}

Hii, M. W. ^{[7
]}

Jacobs, R. ^{[8
]}

机构：

[1] Univ Birmingham, Inst Immunol & Immunotherapy, Birmingham B15 2TT, W Midlands, England

[2] Canberra Hosp, Canberra, ACT, Australia

[3] John Hunter Hosp, New Lambton Hts, NSW, Australia

[4] Nepean Hosp, Kingswood, NSW, Australia

[5] Peter MacCallum Canc Ctr, Melbourne, Vic, Australia

[6] St George Publ & Private Hosp, Sydney, NSW, Australia

[7] St Vincents Hosp Melbourne, Melbourne, Vic, Australia

[8] Western Hosp, Footscray, Vic, Australia

[9] Unicamp Univ Hosp, Campinas, Brazil

[10] St Johns Hosp, St John, NB, Canada

[11] Univ Hlth Network, Toronto Gen Hosp, Toronto, ON, Canada

[12] Univ Rosario, Hosp Univ Mayor Mederi, Rosario, Colombia

[13] Hosp San Ignacio Univ Javeriana, Bogota, Colombia

[14] Univ Hosp Fdn Santafe Bogota, Bogota, Colombia

[15] Univ Clin Erlangen, Erlangen, Germany

[16] Med Univ Goettingen, Gottingen, Germany

[17] Tech Univ Munich, Klinikum Rechts Isar, Munich, Germany

[18] Univ Hosp Hamburg Eppendorf, Hamburg, Germany

[19] Univ Hosp Kiel, Kiel, Germany

[20] Aalborg Univ Hosp, Aalborg, Denmark

[21] Aarhus Univ Hosp, Aarhus, Denmark

[22] Odense Univ Hosp, Odense, Denmark

[23] Copenhagen Univ Hosp, Rigshosp, Copenhagen, Denmark

[24] Oulu Univ Hosp, Oulu, Finland

[25] Univ Athens, Hippokrat Gen Hosp, Athens, Greece

[26] Laikon Gen Hosp, Athens, Greece

[27] St Savvas Canc Hosp, Athens, Greece

[28] Beaumont Hosp, Dublin, Ireland

[29] Univ Hosp Galway, Galway, Ireland

[30] Mercy Univ Hosp, Cork, Ireland

[31] St James Hosp, Dublin, Ireland

[32] Univ Bologna, St Orsola Hosp, Bologna, Italy

[33] Polyclin Hosp Univ Catania, Catania, Italy

[34] Univ Milan, Milan, Italy

[35] Padova Univ Hosp, Padua, Italy

[36] Verona Borgo Trento Hosp, Trento, Italy

[37] Shizioka Canc Ctr, Shizioka, Japan

[38] Tenwek Hosp, Tenwek, Kenya

[39] Chest Dis Hosp, Kuwait, Kuwait

[40] Natl Canc Inst, Mexico City, DF, Mexico

[41] Natl Inst Med Sci & Nutr Salvador Zubiran, Mexico City, DF, Mexico

[42] Univ Malaya Med Ctr, Kuala Lumpur, Malaysia

[43] Carez Hosp, Lagos, Nigeria

[44] Univ Port Harcourt, Teaching Hosp, Port Harcourt, Nigeria

[45] Elisabeth TweeSteden Ziekenhuis Hosp, Tilburg, Netherlands

[46] Radboudumc, Nijmegen, Netherlands

[47] UMC Utrecht, Utrecht, Netherlands

[48] Auckland City Hosp, Auckland, New Zealand

[49] Middlemore Hosp, Auckland, New Zealand

[50] Palmerston North Hosp, Palmerston North, New Zealand

来源：

BJS OPEN | 2021年 / 5卷 / 06期

关键词：

RESIDENT INVOLVEMENT; SURGICAL OUTCOMES; SURGERY; IMPACT; SOCIETY;

D O I：

10.1093/bjsopen/zrab132

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

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.

引用

页数：12

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