Effect of General Surgery Resident Participation in Thoracic Surgery on Oncologic Outcomes: An Observational Cohort Study.

Autor:	Grogan RS; Department of Medical Education, Gundersen Medical Foundation, La Crosse, WI, USA., Wieser AP; Department of Research Navigation, Gundersen Medical Foundation, La Crosse, WI, USA., Bennie BA; Department of Research Navigation, Gundersen Medical Foundation, La Crosse, WI, USA., Fischer CL; Department of Research Navigation, Gundersen Medical Foundation, La Crosse, WI, USA., Paramesh V; Department of Cardiothoracic Surgery, Gundersen Health System, La Crosse, WI, USA., Jarman BT; Department of Medical Education, Gundersen Medical Foundation, La Crosse, WI, USA.; Department of General Surgery, Gundersen Health System, La Crosse, WI, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2024 Dec; Vol. 90 (12), pp. 3235-3243. Date of Electronic Publication: 2024 Jul 26.
DOI:	10.1177/00031348241269407
Abstrakt:	Background: Despite increasing sub-specialization, general surgeons continue to perform oncologic thoracic surgeries. Our objective was to determine whether general surgery resident participation in thoracic surgery affects surgical quality or oncologic outcomes. We hypothesized that patient outcomes with and without resident participation would be similar. Methods: We retrospectively reviewed the electronic health records of patients with stage 0-IV lung cancer undergoing oncologic pulmonary resection at BLINDED FOR REVIEW during an 11-year period (2012-2022). Patients younger than 18 years or older than 85 years were excluded, as were those who had incomplete follow-up data or were unregistered in our institutional cancer registry. Patients were divided into groups based on whether residents or staff surgeons completed >50% of the critical portions of the operation. We compared 30-day morbidity outcomes, overall survival (OS), and disease-free survival (DFS). Results: Three hundred thirteen patients met inclusion criteria. Demographic and clinical characteristics were similar between groups, as were types of surgical resection and median operative times. A statistical difference was found in the distribution of surgical approach. The odds of morbidity were 65% higher in the Staff group (OR=1.65; 95% CI, 1.007-2.71). Resident participation was not significantly associated with OS or DFS ( P =.32 and P =.54, respectively). Discussion: General surgery resident involvement in lung cancer operations is not associated with longer operative times but is associated with a higher likelihood of a thoracotomy. General surgery resident involvement was associated with decreased postoperative morbidity and did not significantly affect OS or DFS. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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