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Trainee performance in radical gastrectomy and its effect on outcomes.

M Navidi¹, A Madhavan¹, S M Griffin¹

¹Northern Oesophago-Gastric Unit, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK.

|February 4, 2020

Summary

Supervised trainee involvement in D2 open gastrectomy did not compromise patient outcomes. This study found no significant differences in morbidity, mortality, or survival rates between consultant and trainee surgeons.

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Area of Science:

Surgical Oncology
Gastrointestinal Surgery
Medical Education

Background:

The role of surgical trainees in complex procedures like D2 gastrectomies is debated.
Assessing the impact of trainee participation on patient outcomes is crucial for surgical training programs.

Purpose of the Study:

To evaluate whether trainee involvement in D2 open gastrectomies is associated with adverse patient outcomes.
To compare short- and long-term clinical outcomes between patients operated on by consultants and those treated by trainees under supervision.

Main Methods:

Retrospective review of a prospectively created database of patients undergoing D2 open total (TG) or subtotal (STG) gastrectomy.
Comparison of outcomes including operative time, lymph node yield, hospital stay, morbidity, mortality, and survival between consultant-led and trainee-led procedures.

Main Results:

No significant differences were observed in operative duration, lymph node yield, hospital stay, overall morbidity, or mortality between consultant and trainee groups.
The trainee cohort experienced significantly lower median blood loss during both TG and STG procedures.
Predicted 5-year overall survival rates showed no significant difference between the two cohorts.

Conclusions:

Supervised trainee involvement in D2 open gastrectomy does not compromise clinical outcomes.
Trainee participation in D2 gastrectomies can be safely performed without adverse effects on patient safety or survival.
This finding supports the continued integration of trainees in advanced gastrointestinal surgical procedures.