Effect of training on patient outcomes following lobectomy.
BACKGROUND
Little is known about the effect of surgical training on outcomes in thoracic surgery. The impact of surgeon training on outcomes following lung resection was examined, focusing on lobectomy as a marker operation.


METHODS
328 consecutive patients who underwent lobectomy at our institution between 1 October 2001 and 30 June 2003 were studied. Data were collected prospectively during the patient's admission as part of routine clinical practice and validated by a designated audit officer. Patient characteristics and postoperative outcomes were compared between trainee led and consultant led operations.


RESULTS
In 115 cases (35.1%) the operation was performed by a trainee thoracic surgeon as the first operator. There were no significant differences in patient characteristics between the two groups. In-hospital mortality was similar for operations led by trainees and consultants (3.5% and 2.8%, respectively; p > 0.99). Outcomes in the two groups did not differ significantly with respect to respiratory, cardiovascular, renal, neurological, chest infection, bleeding, and gastrointestinal complications. Survival rates at 1 year were 82.6% for procedures led by trainees compared with 81.7% for procedures led by consultants (p = 0.83).


CONCLUSIONS
With appropriate supervision, trainee thoracic surgeons can perform lobectomies safely without compromising short or intermediate term patient outcome.
Chaudhuri
N
N
Department of Cardiothoracic Surgery, The Cardiothoracic Centre, Liverpool L14 3PE, UK.
Grayson
A D
AD
Grainger
R
R
Mediratta
N K
NK
Carr
M H
MH
Soorae
A S
AS
Page
R D
RD
D000368:Aged; D002983:Clinical Competence / Q000592:standards; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D006801:Humans; D007318:Inservice Training; D008168:Lung / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D013903:Thoracic Surgery / Q000193:education*; D016896:Treatment Outcome