Postoperative outcomes in oesophagectomy with trainee involvement

Evans, R.P.T.; Kamarajah, S.K.; Bundred, J.; Nepogodiev, D.; Hodson, J.; Griffiths, E.A.; Alderson, D.; Jefferies, B.; Siaw-Acheampong, K.; Wanigasooriya, K.; Whitehouse, T.; Gjata, A.; Moreno, J.I.; Takeda, F.R.; Kidane, B.; Guevara Castro, R.; Harustiak, T.; Bekele, A.; Kechagias, A.; Gockel, I.; Kennedy, A.; Da Roit, A.; Bagajevas, A.; Azagra, J.S.; Mahendran, H.A.; Mejía-Fernández, 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.; Wills, V.; Devadas, M.; Duong, C.; Talbot, M.; Hii, M.W.; Jacobs, R.; Andreollo, N.A.; Johnston, B.; Darling, G.; Isaza-Restrepo, A.; Rosero, G.; Arias-Amézquita, F.; Raptis, D.; Gaedcke, J.; Reim, D.; Izbicki, J.; Egberts, J.H.; Dikinis, S.; Kjaer, D.W.; Larsen, M.H.; Achiam, M.P.; Saarnio, J.; Theodorou, D.; Liakakos, T.; Korkolis, D.P.; Robb, W.B.; Collins, C.; Murphy, T.; Reynolds, J.; Tonini, V.; Migliore, M.; Bonavina, L.; Valmasoni, M.; Bardini, R.; Weindelmayer, J.; Terashima, M.; White, R.E.; Alghunaim, E.; Elhadi, M.; Leon-Takahashi, A.M.; Medina-Franco, H.; Lau, P.C.; Okonta, K.E.; Heisterkamp, J.; Rosman, C.; van Hillegersberg, R.; Beban, G.; Babor, R.; Gordon, A.; Rossaak, J.I.; Pal, K.M.I.; Qureshi, A.U.; Naqi, S.A.; Syed, A.A.; Barbosa, J.; Vicente, C.S.; Leite, J.; Freire, J.; Casaca, R.; Costa, R.C.T.; Scurtu, R.R.; Mogoanta, S.S.; Bolca, C.; Constantinoiu, S.; Sekhniaidze, D.; Bjelovic, M.; So, J.B.Y.; Gacevski, G.; Loureiro, C.; Pera, M.; Bianchi, A.; Gijón, M.; Fernández, J.; Carrera, M.S.; Vallve-Bernal, M.; Pascual, M.A.; Elmahi, S.; Halldestam, I.; Hedberg, J.; Mönig, S.; Gutknecht, S.; Tez, M.; Guner, A.; Tirnaksiz, T.B.; Colak, E.; Sevinç, B.; Hindmarsh, A.; Khan, I.; Khoo, D.; Byrom, R.; Gokhale, J.; Wilkerson, P.; Jain, P.; Chan, D.; Robertson, K.; Iftikhar, S.; Skipworth, R.; Forshaw, M.; Higgs, S.; Gossage, J.; Nijjar, R.; Viswanath, Y.K.S.; Turner, P.; Dexter, S.; Boddy, A.; Allum, W.H.; Oglesby, S.; Cheong, E.; Beardsmore, D.; Vohra, R.; Maynard, N.; Berrisford, R.; Mercer, S.; Puig, S.; Melhado, R.; Kelty, C.; Underwood, T.; Dawas, K.; Lewis, W.; Al-Bahrani, A.; Bryce, G.; Thomas, M.; Arndt, A.T.; Palazzo, F.; Meguid, R.A.; Fergusson, J.; Beenen, E.; Mosse, C.; Salim, J.; Cheah, S.; Wright, T.; Cerdeira, M.P.; McQuillan, P.; Richardson, M.; Liem, H.; Spillane, J.; Yacob, M.; Albadawi, F.; Thorpe, T.; Dingle, A.; Cabalag, C.; Loi, K.; Fisher, O.M.; Ward, S.; Read, M.; Johnson, M.; Bassari, R.; Bui, H.; Cecconello, I.; Sallum, R.A.A.; da Rocha, J.R.M.; Lopes, L.R.; Tercioti, V.; Coelho, J.D.S.; Ferrer, J.A.P.; Buduhan, G.; Tan, L.; Srinathan, S.; Shea, P.; Yeung, J.; Allison, F.; Carroll, P.; Vargas-Barato, F.; Gonzalez, F.; Ortega, J.; Nino-Torres, L.; Beltrán-García, T.C.; Castilla, L.; Pineda, M.; Bastidas, A.; Gómez-Mayorga, J.; Cortés, N.; Cetares, C.; Caceres, S.; Duarte, S.; Pazdro, A.; Snajdauf, M.; Faltova, H.; Sevcikova, M.; Mortensen, P.B.; Katballe, N.; Ingemann, T.; Morten, B.; Kruhlikava, I.; Ainswort, A.P.; Stilling, N.M.; Eckardt, J.; Holm, J.; Thorsteinsson, M.; Siemsen, M.; Brandt, B.; Nega, B.; Teferra, E.; Tizazu, A.; Kauppila, J.S.; Koivukangas, V.; Meriläinen, S.; Gruetzmann, R.; Krautz, C.; Weber, G.; Golcher, H.; Emons, G.; Azizian, A.; Ebeling, M.; Niebisch, S.; Kreuser, N.; Albanese, G.; Hesse, J.; Volovnik, L.; Boecher, U.; Reeh, M.; Triantafyllou, S.; Schizas, D.; Michalinos, A.; Baili, E.; Mpoura, M.; Charalabopoulos, A.; Manatakis, D.K.; Balalis, D.; Bolger, J.; Baban, C.; Mastrosimone, A.; McAnena, O.; Quinn, A.; Súilleabháin, C.B.Ó.; Hennessy, M.M.; Ivanovski, I.; Khizer, H.; Ravi, N.; Donlon, N.; Cervellera, M.; Vaccari, S.; Bianchini, S.; Sartarelli, L.; Asti, E.; Bernardi, D.; Merigliano, S.; Provenzano, L.; Scarpa, M.; Saadeh, L.; Salmaso, B.; De Manzoni, G.; Giacopuzzi, S.; La Mendola, R.; De Pasqual, C.A.; Tsubosa, Y.; Niihara, M.; Irino, T.; Makuuchi, R.; Ishii, K.; Mwachiro, M.; Fekadu, A.; Odera, A.; Mwachiro, E.; AlShehab, D.; Ahmed, H.A.; Shebani, A.O.; Elhadi, A.; Elnagar, F.A.; Elnagar, H.F.; Makkai-Popa, S.T.; Wong, L.F.; Yunrong, T.; Thanninalai, S.; Aik, H.C.; Soon, P.W.; Huei, T.J.; Basave, H.N.L.; Cortés-González, R.; Lagarde, S.M.; van Lanschot, J.J.B.; Cords, C.; Jansen, W.A.; Martijnse, I.; Matthijsen, R.; Bouwense, S.; Klarenbeek, B.; Verstegen, M.; van Workum, F.; Ruurda, J.P.; van der Veen, A.; van den Berg, J.W.; Evenett, N.; Johnston, P.; Patel, R.; MacCormick, A.; Young, M.; Smith, B.; Ekwunife, C.; Memon, A.H.; Shaikh, K.; Wajid, A.; Khalil, N.; Haris, M.; Mirza, Z.U.; Qudus, S.B.A.; Sarwar, M.Z.; Shehzadi, A.; Raza, A.; Jhanzaib, M.H.; Farmanali, J.; Zakir, Z.; Shakeel, O.; Nasir, I.; Khattak, S.; Baig, M.; Noor, M.A.; Ahmed, H.H.; Naeem, A.; Pinho, A.C.; da Silva, R.; Bernardes, A.; Campos, J.C.; Matos, H.; Braga, T.; Monteiro, C.; Ramos, P.; Cabral, F.; Gomes, M.P.; Martins, P.C.; Correia, A.M.; Videira, J.F.; Drasovean, R.; Apostu, R.; Ciuce, C.; Ciuce, C.; Paitici, S.; Racu, A.E.; Obleaga, C.V.; Beuran, M.; Stoica, B.; Ciubotaru, C.; Negoita, V.; Cordos, I.; Birla, R.D.; Predescu, D.; Hoara, P.A.; Tomsa, R.; Shneider, V.; Agasiev, M.; Ganjara, I.; Gunjic, D.; Veselinovic, M.; Babic, T.; Chin, T.S.; Shabbir, A.; Kim, G.; Crnjac, A.; Samo, H.; Díez del Val, I.; Leturio, S.; Ramón, J.M.; Dal Cero, M.; Rifá, S.; Rico, M.; Pomar, A.; Corcoles, J.A.; Miravalles, J.L.; Pais, S.A.; Turienzo, S.A.; Alvarez, L.S.; Campos, P.V.; Rendo, A.G.; García, S.S.; Santos, E.P.G.; Martínez, E.T.; Díaz, M.J.; Álvarez, C.; Martín, V.; Díaz López, C.; Rodrigo, A.; Sánchez, L.E.; Cuadrado, M.; Carrasco, C.; Bhojwani, E.; Sánchez, D.P.; Ahmed, M.E.; Dzhendov, T.; Lindberg, F.; Rutegård, M.; Sundbom, M.; Mickael, C.; Colucci, N.; Schnider, A.; Er, S.; Kurnaz, E.; Turkyilmaz, S.; Turkyilmaz, A.; Yildirim, R.; Baki, B.E.; Akkapulu, N.; Karahan, O.; Damburaci, N.; Hardwick, R.; Safranek, P.; Sujendran, V.; Bennett, J.; Afzal, Z.; Shrotri, M.; Chan, B.; Exarchou, K.; Gilbert, T.; Amalesh, T.; Mukherjee, D.; Mukherjee, S.; Wiggins, T.H.; Kennedy, R.; McCain, S.; Harris, A.; Dobson, G.; Davies, N.; Wilson, I.; Mayo, D.; Bennett, D.; Young, R.; Manby, P.; Blencowe, N.; Schiller, M.; Byrne, B.; Mitton, D.; Wong, V.; Elshaer, A.; Cowen, M.; Menon, V.; Tan, L.C.; McLaughlin, E.; Koshy, R.; Sharp, C.; Brewer, H.; Das, N.; Cox, M.; Al Khyatt, W.; Worku, D.; Iqbal, R.; Walls, L.; McGregor, R.; Fullarton, G.; Macdonald, A.; MacKay, C.; Craig, C.; Dwerryhouse, S.; Hornby, S.; Jaunoo, S.; Wadley, M.; Baker, C.; Saad, M.; Kelly, M.; Davies, A.; Di Maggio, F.; McKay, S.; Mistry, P.; Singhal, R.; Tucker, O.; Kapoulas, S.; Powell-Brett, S.; Davis, P.; Bromley, G.; Watson, L.; Verma, R.; Ward, J.; Shetty, V.; Ball, C.; Pursnani, K.; Sarela, A.; Ling, H.; Mehta, S.; Hayden, J.; To, N.; Palser, T.; Hunter, D.; Supramaniam, K.; Butt, Z.; Ahmed, A.; Kumar, S.; Chaudry, A.; Moussa, O.; Kordzadeh, A.; Lorenzi, B.; Wilson, M.; Patil, P.; Noaman, I.; Willem, J.; Bouras, G.; Evans, R.; Singh, M.; Warrilow, H.; Ahmad, A.; Tewari, N.; Yanni, F.; Couch, J.; Theophilidou, E.; Reilly, J.J.; Singh, P.; van Boxel, G.; Akbari, K.; Zanotti, D.; Sgromo, B.; Sanders, G.; Wheatley, T.; Ariyarathenam, A.; Reece-Smith, A.; Humphreys, L.; Choh, C.; Carter, N.; Knight, B.; Pucher, P.; Athanasiou, A.; Mohamed, I.; Tan, B.; Abdulrahman, M.; Vickers, J.; Akhtar, K.; Chaparala, R.; Brown, R.; Alasmar, M.M.A.; Ackroyd, R.; Patel, K.; Tamhankar, A.; Wyman, A.; Walker, R.; Grace, B.; Abbassi, N.; Slim, N.; Ioannidi, L.; Blackshaw, G.; Havard, T.; 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.; Chmielewski, G.; Rosato, E.L.; Berger, A.C.; Zheng, R.; Okolo, E.; Singh, A.; Scott, C.D.; Weyant, M.J.; Mitchell, J.D.

doi:10.1093/bjsopen/zrab132

Postoperative outcomes in oesophagectomy with trainee involvement

Atıf İçin Kopyala

Evans R., Kamarajah S., Bundred J., Nepogodiev D., Hodson J., Griffiths E., ...Daha Fazla

BJS Open, cilt.5, sa.6, 2021 (SCI-Expanded)

Yayın Türü: Makale / Tam Makale
Cilt numarası: 5 Sayı: 6
Basım Tarihi: 2021
Doi Numarası: 10.1093/bjsopen/zrab132
Dergi Adı: BJS Open
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Directory of Open Access Journals
Uşak Üniversitesi Adresli: Evet

Özet

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 ¼ 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 ¼ 0.451, P ¼ 0.318, and P ¼ 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P ¼ 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P ¼ 0.150, P ¼ 0.430, and P ¼ 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P ¼ 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.