Should oesophagectomies be performed by trainees? The experience from a single teaching centre under the supervision of one surgeon.
BACKGROUND
Surgical training is threatened by anxieties about trainees performing major procedures. We have analysed the outcome of oesophagectomies performed by a consultant surgeon and compared these to the performance of trainees (years 4-6) operating under direct supervision.


METHODS
Data were collected retrospectively in a computerised database on all patients who underwent oesophagectomy at a teaching tertiary centre between December 1997 and April 2004 with a minimum 15 months' follow-up. Analysis of outcome was according to measures of technical adequacy, postoperative course, histological analysis, recurrence and survival.


RESULTS
During the study period, 241 oesophagectomies were carried out; 157 (65.1%) of these procedures were performed by the consultant and 84 (34.9%) were performed by surgeons-in-training under direct consultant supervision. Pre-operative, technical adequacy, postoperative course, histological analysis, recurrence and survival were comparable in both groups.


CONCLUSIONS
These data demonstrate comparable patient outcome when suitably experienced trainees are supervised in performing oesophagectomies and support its continued use in operative training.
Baron
Ryan
R
Oxford OesophagoGastric Unit, The John Radcliffe Hospital, Oxford, UK.
Sujendran
Vijay
V
Maynard
Nicholas
N
D002983:Clinical Competence / Q000592:standards*; D003253:Consultants; D004503:Education, Medical, Graduate / Q000379:methods*; D004739:England; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education; D008875:Middle Aged; D012189:Retrospective Studies; D013663:Teaching / Q000379:methods*