Open AccessPostoperative outcomes in oesophagectomy with trainee involvement
Author(s) -
Richard Evans,
Sivesh K. Kamarajah,
James Bundred,
Dmitri Nepogodiev,
James Hodson,
Richard van Hillegersberg,
James Gossage,
Ravinder Vohra,
Ewen A. Griffiths,
Pritam Singh,
Derek Alderson,
Benjamin J Jefferies,
S McKay,
I. Mohamed,
K. Siaw- Acheampong,
Kasun Wanigasooriya,
Tony Whitehouse,
Arben Gjata,
J Moreno,
Flávio Roberto Takeda,
B Kidane,
R Guevara Castro,
Tomáš Haruštiak,
Abebe Bekele,
Aristotelis Kechagias,
Ines Gockel,
Andrew Kennedy,
Anna Da Roit,
Aleksandras Bagajevas,
J. S. Azagra,
Hans Alexander Mahendran,
Lorelí Mejía-Fernández,
Bas P. L. Wijnhoven,
Jihène El Kafsi,
Raza Sayyed,
Marcos Vinícius de Sousa,
Ana Sampaio,
Ionuţ Negoi,
RV Blanco,
Bengt Wallner,
Paul M. Schneider,
PoKuei Hsu,
Arda Işık,
Sivakumar Gananadha,
Vanessa Wills,
Michael Devadas,
C Duong,
M.F. Talbot,
Michael W. Hii,
Rebecca Jacobs,
N.A Andreollo,
Brian Johnston,
Gail Darling,
Andrés Isaza-Restrepo,
Germán Rosero,
Fernando Arias,
Dimitrios Raptis,
Jochen Gaedcke,
Daniel Reim,
Jakob R. Izbicki,
JanHendrik Egberts,
Sarunas Dikinis,
D W Kjaer,
M H Larsen,
M P Achiam,
Juha Saarnio,
Dimitris Theodorou,
Theodore Liakakos,
Dimitrios Korkolis,
William B. Robb,
Chris Collins,
Thomas J. Murphy,
John V. Reynolds,
Valeria Tonini,
Marcello Migliore,
Luigi Bonavina,
Michele Valmasoni,
Romeo Bardini,
Jacopo Weindelmayer,
Masanori Terashima,
Russell E. White,
Essa AlGhunaim,
Muhammed Elhadi,
Alberto M. León-Takahashi,
Heriberto MedinaFranco,
Peng Choong Lau,
KelechiE Okonta,
Joos Heisterkamp,
Camiel Rosman,
Grant Beban,
Richard Babor,
A. Gordon,
Jeremy Rossaak,
Kamalesh Pal,
A. Qureshi,
Syed Asghar Naqi,
Aneesa Syed,
José Barbosa,
Cristina Vicente,
Jackson Filho Vila Nova Leite,
J. Freire,
Rui Casaca,
R.C.T. Costa,
R R Scurtu,
S.S. Mogoanta,
Ciprian Bolca,
S Constantinoiu,
D. Sekhniaidze,
Miloš Bjelović,
Jimmy Bok Yan So,
Goran Gačevski,
Carlos Loureiro,
Manuel Pera,
Alberto Bianchi,
María Moreno Gijón,
José Martín Fernández,
M.S. Trugeda Carrera,
Marc Vallvè-Bernal,
Manuel Pascual,
S. Elmahi,
Jakob Hedberg,
SP Mönig,
Stefan Gutknecht,
Mesut Tez,
Ali Güner,
T B Tirnaksiz,
Elif Çolak,
Barış Sevinç,
Andrew Hindmarsh,
Iqbal M. Khan,
David Khoo,
Richard Byrom,
Jay Gokhale,
Paul M Wilkerson,
Prashant Jain,
David Chan,
K Robertson,
Syed Iftikhar,
Richard J. E. Skipworth,
M Forshaw,
Simon Higgs,
Rajwinder Nijjar,
Yks Viswanath,
Paul Turner,
S. P. L. Dexter,
Alex Boddy,
William Allum,
Stuart Oglesby,
E Cheong,
Duncan Beardsmore,
Nick Maynard,
Richard Berrisford,
S Mercer,
Susana Puig,
Rachel Melhado,
C Kelty,
Timothy J. Underwood,
Khaled Dawas,
Wyn G. Lewis,
Ahmed Z. Al-Bahrani,
Gavin Bryce,
Mathew Thomas,
Andrew Arndt,
Francesco Palazzo,
Robert A. Meguid,
James Fergusson,
Edwin Beenen,
Charles A. Mosse,
Joshua Salim,
S Cheah,
Timothy Wright,
M P Cerdeira,
Patrick McQuillan,
Mark P. Richardson,
Han Liem,
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Myla Yacob,
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Ann F. Dingle,
Carlos S. Cabalag,
Ken Loi,
Oliver M. Fisher,
S Ward,
Matthew Read,
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Hai T. Bui,
Ivan Cecconello,
Rubens Antônio Aissar Sallum,
J. R. M Rocha,
Luís R. Lopes,
Valdir Tercioti,
Joshua Coelho,
José Antonio Possatto Ferrer,
Gordon Buduhan,
Lijie Tan,
Sadeesh Srinathan,
P Shea,
Jonathan Yeung,
Frances Allison,
Paul Carroll,
Felipe Vargas-Barato,
Felipe González,
Joaquín Ortega,
Laura Niño Torres,
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L. Castilla,
Miguel A. Pineda,
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Jorge L. Gomez-Mayorga,
Natalia Cortés,
C. Cetares,
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Sebastião Júnior Henrique Duarte,
A Pazdro,
Martin Snajdauf,
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Mara C. Ebeling,
Stefan Niebisch,
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Adamantios Michalinos,
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Maria Mpoura,
Alexandros Charalabopoulos,
Dimitrios K. Manatakis,
Dimitrios Balalis,
Jarlath Bolger,
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Roberta La Mendola,
Carlo Alberto De Pasqual,
Yasuhiro Tsubosa,
Masahiro Niihara,
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Khalid Akbari,
Daniela Zanotti,
Bruno Sgromo,
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Farhan Rashid,
Periyathambi Jambulingam,
J. Padickakudi,
Hakim Benyounes,
Kirsty McCormack,
Ian A. Makey,
M.K. Karush,
Christopher W. Seder,
Jun Li,
G. Chmielewski,
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Publication year - 2021
Publication title -
bjs open
Language(s) - English
Resource type - Journals
ISSN - 2474-9842
DOI - 10.1093/bjsopen/zrab132
Subject(s) - medicine , anastomosis , esophagectomy , complication , surgery , leak , general surgery , cohort , cohort study , esophageal cancer , cancer , environmental engineering , engineering
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.
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