[Does Surgeons' Experience Affect the Surgical Outcomes of Total Arch Replacement?]
Atsushi Omura1, Taishi Inoue, Mari Hamaguchi
1Department of Cardiovascular Surgery, Kobe University, Kobe, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|April 8, 2021
Summary
Standardized total arch replacement (TAR) procedures minimize the impact of surgeon experience on patient outcomes. This approach ensures consistent safety and effectiveness, regardless of the surgeon
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Surgical Standardization
Background:
- Total arch replacement (TAR) is a complex and invasive aortic procedure.
- Standardization is crucial for ensuring safety and effectiveness in TAR.
- The influence of surgeon experience on TAR outcomes requires investigation.
Purpose of the Study:
- To analyze the impact of surgeon experience on surgical outcomes of TAR.
- To evaluate the effectiveness of a standardized TAR procedure.
- To determine if standardization mitigates the influence of surgeon experience.
Main Methods:
- 346 patients underwent elective TAR between 2008 and 2020.
- Surgeons were classified into three experience groups (A: >20 years, B: 15-20 years, C: <15 years).
- A standardized approach included specific cannulation, cerebral perfusion, temperature, rewarming, and fluid balance protocols.
Main Results:
- No significant difference in hospital mortality or major complication rates among surgeon experience groups.
- Multivariate analysis confirmed surgeon experience was not associated with mortality or complications.
- Long-term outcomes were comparable across all surgeon experience levels.
Conclusions:
- The developed standardization for TAR effectively minimizes the impact of surgeon experience on outcomes.
- Appropriate surgeon selection based on operative difficulty is key to successful standardization.
- Standardized TAR procedures enhance patient safety and procedural consistency.
