Oesophago-Gastric Anastomosis Study Group (OGAA) on behalf of the West Midlands Research Collaborative, Postoperative outcomes in oesophagectomy with trainee involvement, BJS Open, Volume 5, Issue 6, November 2021, zrab132, https://doi.org/10.1093/bjsopen/zrab132
Postoperative outcomes in oesophagectomy with trainee involvement
|Author:||Evans, R. P. T.1; Hodson, J.1; Kamarajah, S. K.1;|
1Univ Birmingham, Inst Immunol & Immunotherapy, Birmingham B15 2TT, W Midlands, England.
2Nottingham Univ Hosp, Nottingham, England.
3Guys & St Thomas Hosp, London, England.
4Heartlands Hosp, Coventry, W Midlands, England.
5Queen Elizabeth Hosp Birmingham, Birmingham, W Midlands, England.
6UMC Utrecht, Utrecht, Netherlands.
7Canberra Hosp, Canberra, ACT, Australia.
8John Hunter Hosp, New Lambton Hts, NSW, Australia.
9Nepean Hosp, Kingswood, NSW, Australia.
10Peter MacCallum Canc Ctr, Melbourne, Vic, Australia.
11St George Publ & Private Hosp, Sydney, NSW, Australia.
12St Vincents Hosp Melbourne, Melbourne, Vic, Australia.
13Western Hosp, Footscray, Vic, Australia.
14Unicamp Univ Hosp, Campinas, Brazil.
15St Johns Hosp, St John, NB, Canada.
16Univ Hlth Network, Toronto Gen Hosp, Toronto, ON, Canada.
17Univ Rosario, Hosp Univ Mayor Mederi, Rosario, Colombia.
18Hosp San Ignacio Univ Javeriana, Bogota, Colombia.
19Univ Hosp Fdn Santafe Bogota, Bogota, Colombia.
20Univ Clin Erlangen, Erlangen, Germany.
21Med Univ Goettingen, Gottingen, Germany.
22Tech Univ Munich, Klinikum Rechts Isar, Munich, Germany.
23Univ Hosp Hamburg Eppendorf, Hamburg, Germany.
24Univ Hosp Kiel, Kiel, Germany.
25Aalborg Univ Hosp, Aalborg, Denmark.
26Aarhus Univ Hosp, Aarhus, Denmark.
27Odense Univ Hosp, Odense, Denmark.
28Copenhagen Univ Hosp, Rigshosp, Copenhagen, Denmark.
29Oulu Univ Hosp, Oulu, Finland.
30Univ Athens, Hippokrat Gen Hosp, Athens, Greece.
31Laikon Gen Hosp, Athens, Greece.
32St Savvas Canc Hosp, Athens, Greece.
33Beaumont Hosp, Dublin, Ireland.
34Univ Hosp Galway, Galway, Ireland.
35Mercy Univ Hosp, Cork, Ireland.
36St James Hosp, Dublin, Ireland.
37Univ Bologna, St Orsola Hosp, Bologna, Italy.
38Polyclin Hosp Univ Catania, Catania, Italy.
39Univ Milan, Milan, Italy.
40Padova Univ Hosp, Padua, Italy.
41Verona Borgo Trento Hosp, Trento, Italy.
42Shizioka Canc Ctr, Shizioka, Japan.
43Tenwek Hosp, Tenwek, Kenya.
44Chest Dis Hosp, Kuwait, Kuwait.
45Natl Canc Inst, Mexico City, DF, Mexico.
46Natl Inst Med Sci & Nutr Salvador Zubiran, Mexico City, DF, Mexico.
47Univ Malaya Med Ctr, Kuala Lumpur, Malaysia.
48Carez Hosp, Lagos, Nigeria.
49Univ Port Harcourt, Teaching Hosp, Port Harcourt, Nigeria.
50Elisabeth TweeSteden Ziekenhuis Hosp, Tilburg, Netherlands.
51Radboudumc, Nijmegen, Netherlands.
52Auckland City Hosp, Auckland, New Zealand.
53Middlemore Hosp, Auckland, New Zealand.
54Palmerston North Hosp, Palmerston North, New Zealand.
55Bay Plenty Dist Hlth Board, Tauranga Hosp, Tauranga, New Zealand.
56Aga Khan Univ Hosp, Karachi, Pakistan.
57Serv Inst Med Sci, Karachi, Pakistan.
58Mayo Hosp, Lahore, Pakistan.
59Shaukat Khanum Mem Canc Hosp & Res Ctr Lahore, Lahore, Pakistan.
60Ctr Hosp Sao Joao, Porto, Portugal.
61Ctr Hosp Lisboa Cent, Lisbon, Portugal.
62Coimbra Univ Hosp, Coimbra, Portugal.
63Hosp Santa Maria, Lisbon, Portugal.
64Inst Portugues Oncol Lisboa, Lisbon, Portugal.
65Inst Portugues Oncol Porto, Porto, Portugal.
66Univ Emergency Cluj Cty Hosp, Cluj Napoca, Romania.
67Emergency Cty Hosp Craiova, Craiova, Romania.
68Marius Nasta Natl Inst Pneumol, Bucharest, Romania.
69St Mary Clin Hosp, Petrosani, Romania.
70Tyumen Reg Hosp, Tyumen, Russia.
71Univ Hosp Digest Surg, Clin Ctr Serbia, Dept Minimally Invas Upper Digest Surg, Belgrade, Serbia.
72Natl Univ Singapore Hosp, Singapore, Singapore.
73Univ Hosp Maribor, Maribor, Slovenia.
74Univ Hosp Basurto Bilbao, Bilbao, Spain.
75Hosp Univ del Mar, Barcelona, Spain.
76Hosp Univ Cent Asturias, Oviedo, Spain.
77Hosp Gen Univ Ciudad Real, Ciudad Real, Spain.
78Hosp Univ Marques de Valdecilla, Santander, Spain.
79Hosp Univ Nuestra Senora de Candelaria, Santa Cruz De Tenerife, Spain.
80Hosp Univ Rio Hortega Valladolid, Valladolid, Spain.
81Shaab Teaching Hosp, Khartoum, Sweden.
82Univ Hosp Linkoping, Linkoping, Sweden.
83Uppsala Univ Hosp, Uppsala, Sweden.
84Geneva Univ Hosp, Geneva, Switzerland.
85Triemli Hosp Zurich, Zurich, Switzerland.
86Ankara Numune Hosp, Ankara, Turkey.
87Karadeniz Tech Univ, Trabzon, Turkey.
88Hacettepe Univ Hosp, Ankara, Turkey.
89Univ Hlth Sci, Samsun Training & Res Hosp, Samsun, Turkey.
90Usak Univ Training & Res Hosp, Usak, Turkey.
91Addenbrookes Hosp, Cambridge, England.
92Aintree Univ Hosp NHS Fdn Trust, Liverpool, Merseyside, England.
93Barking Havering & Redbridge NHS Trust, Romford, Essex, England.
94Royal Bournemouth Hosp, Bournemouth, Dorset, England.
95Bradford Royal Infirm, Bradford, W Yorkshire, England.
96Univ Hosp Bristol NHS Fdn Trust, Bristol, Avon, England.
97Castle Hill Hosp, Cottingham, England.
98Univ Hosp Coventry, Coventry, W Midlands, England.
99Univ Hosp Crosshouse, Crosshouse, Scotland.
100Royal Derby Hosp, Derby, England.
101Edinburgh Royal Infirm, Edinburgh, Midlothian, Scotland.
102Glasgow Royal Infirm, Glasgow, Lanark, Scotland.
103Gloucester Royal Hosp, Gloucester, England.
104James Cook Univ Hosp, Middlesbrough, Cleveland, England.
105Lancashire Teaching Hosp NHS Fdn Trust, Preston, Lancs, England.
106Leeds Teaching Hosp NHS Trust, Leeds, W Yorkshire, England.
107Univ Hosp Leicester NHS Trust, Leicester, Leics, England.
108Royal Marsden Hosp, London, England.
109Ninewells Hosp, London, England.
110Norfolk & Norwich Univ Hosp, Norwich, Norfolk, England.
111Univ Hosp North Midlands, Stoke On Trent, Staffs, England.
112Oxford Univ Hosp, Oxford, England.
113Plymouth Hosp NHS Trust, Plymouth, Devon, England.
114Queen Alexandra Hosp, Portsmouth, Hants, England.
115Salford Royal Fdn Trust, Salford, Lancs, England.
116Sheffield Teaching Hosp NHS Fdn Trust, Sheffield, S Yorkshire, England.
117Univ Hosp Southampton NHS Fdn Trust, Southampton, Hants, England.
118Univ Coll Hosp, London, England.
119Univ Hosp Wales, Cardiff, Wales.
120Watford Dist Gen Hosp, Watford, England.
121Univ Hosp Wishaw, Wishaw, Scotland.
122Mayo Clin Florida, Jacksonville, FL USA.
123Rush Univ Med Ctr, Chicago, IL USA.
124Thomas Jefferson Univ, Philadelphia, PA 19107 USA.
125Univ Colorado Hosp, Aurora, CO USA.
126Univ Sao Paulo, Hosp Clin, Sch Med, Sao Paulo, Brazil.
127Hlth Sci Ctr Winnipeg, Winnipeg, MB, Canada.
128Hosp Univ Mayor Mederi Univ Rosario, Rosario, Colombia.
129Univ Javeriana, Hosp San Ignacio, Bogota, Colombia.
130Motol Univ Hosp, Prague, Czech Republic.
131Tikur Anbessa Specialized Hosp, Addis Ababa, Ethiopia.
132Univ Klinium Leipzig, Leipzig, Germany.
133Univ Milan, IRCCS Policlin San Donato, Milan, Italy.
134Padova Univ Hosp, Clin Chirurg, Padua, Italy.
135Padova Univ Hosp, Gen Surg Dept, Padua, Italy.
136Ctr Hosp Luxembourg, Luxembourg, Luxembourg.
137Hosp Sultanah Aminah, Johor Baharu, Malaysia.
138Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, Mexico.
139Erasmus MC, Rotterdam, Netherlands.
140Patel Hosp, Karachi, Pakistan.
141Belfast City Hosp, Belfast, Antrim, North Ireland.
|Online Access:||PDF Full Text (PDF, 0.3 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2022040527165
John Wiley & Sons,
|Publish Date:|| 2022-04-05
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).
Conclusions: 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.
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3126 Surgery, anesthesiology, intensive care, radiology
© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.