Repair of oesophageal atresia by consultants and supervised trainees results in similar outcomes
| Autor: | Ron O, Keys Sc, Jones Ce, R Wheeler, Kitteringham L, Nigel J. Hall, Stanton Mp, Smyth R |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Consultants 030230 surgery 03 medical and health sciences 0302 clinical medicine Gastrointestinal Surgery medicine Humans Esophageal Atresia Digestive System Surgical Procedures Retrospective Studies business.industry General surgery Infant Newborn General Medicine medicine.disease Surgical training Education Medical Graduate Atresia Surgery Female Clinical Competence Outcomes research business Follow-Up Studies |
| Zdroj: | Ann R Coll Surg Engl |
| ISSN: | 1478-7083 |
| Popis: | Introduction Consultants and trainees require exposure to complex cases for maintaining and gaining operative experience. Oesophageal atresia (OA) repair is a neonatal surgical procedure with indicative numbers for completion of training. A conflict of interest may exist between adequate training, maintaining consultant experience and achieving good outcomes. We aimed to review outcomes of procedures performed primarily by trainees and those performed by consultants. Methods We carried out a retrospective case note review of all consecutive infants who underwent surgical repair of OA with distal tracheooesophageal fistula (TOF) between January 1994 and December 2014 at our institution. Only cases that underwent primary oesophageal anastomosis were included. Surgical outcomes were compared between cases that had a trainee and those that had a consultant listed as the primary operator. Results One hundred and twenty-two cases were included. A total of 52 procedures were performed by trainees, and 68 by consultants. Two cases were undeterminable and excluded. Infant demographics, clinical characteristics and duration of follow-up were similar between groups. All infants survived to discharge. Procedures performed by trainees and those performed by consultants as primary operators had a similar incidence of postoperative pneumothorax (trainees 4, consultants 3; p=0.46), anastomotic leak (trainees 5, consultants 3; p=0.29) and recurrent TOF (trainees 0, consultants 2; p=0.5). Overall 52% of cases had an anastomotic dilatation during follow-up, with no difference between the trainee and consultant groups (50% vs 53%; p=0.85). Conclusions Surgical outcomes for repair of OA/TOF are not adversely affected by trainee operating. Trainees with appropriate skills should perform supervised OA/TOF repair. These data are important for understanding the interrelationship between provision of training and surgical outcomes. |
| Databáze: | OpenAIRE |
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