Thoracoscopic lobectomy: is a training program feasible with low postoperative morbidity?

Area of Science:

• Thoracic Surgery
• Surgical Education
• Minimally Invasive Surgery

Background:

• Video-assisted thoracic surgery (VATS) lobectomy is a standard procedure for lung cancer.
• Training surgeons in VATS lobectomy requires evaluation of its feasibility and impact on patient outcomes.
• Comparing outcomes between established consultants and surgical trainees is crucial for assessing training programs.

Purpose of the Study:

• To assess the feasibility of a training program in VATS lobectomy.
• To compare intraoperative and postoperative outcomes between patients operated on by established consultants and surgical trainees.
• To determine if trainee involvement impacts operative time, conversion rates, and complication rates.

Main Methods:

• Retrospective analysis of 100 consecutive VATS lobectomies performed between May 2008 and May 2012.
• Patients were divided into two groups: Group A (66 patients operated on by a consultant) and Group B (34 patients operated on by trainees).
• Comparison of clinical characteristics, pathological staging, operative time, conversion rates, complication rates, drain removal time, and hospital stay.

Main Results:

• No significant differences were observed in operating time (125 ± 30 min vs. 133 ± 26 min, p = 0.18) between consultant and trainee groups.
• Conversion rates (9.1% vs. 8.8%, p = 0.6) and complication rates (36.3% vs. 32.3%, p = 0.4) were comparable between the groups.
• Median time to drain removal (3 days vs. 3 days) and median length of hospital stay (5.5 days vs. 5 days) showed no statistical differences (p = 0.3 and p = 0.5, respectively).

Conclusions:

• A training program for VATS lobectomy is feasible.
• Trainee participation in VATS lobectomy does not increase operative time, conversion rate, or postoperative complications.
• The training program allows for comparable patient outcomes regarding drain removal time and hospital stay.