Identifying High-Risk Patients for Trainee Residents in Thoracoscopic Anatomical Lung Resection: Enhancing Safe...

Area of Science:

• Thoracic Surgery
• Surgical Education
• Patient Safety

Background:

• Postoperative complications pose risks in thoracic surgery, particularly for trainee residents with limited experience.
• Early-stage residents performing thoracoscopic anatomical lung resections for non-small cell lung cancer require identification of specific risk factors.

Purpose of the Study:

• To identify preoperative and intraoperative risk factors associated with postoperative complications in early-stage thoracic surgery trainee residents.
• To improve patient safety and training outcomes by understanding factors influencing complication rates.

Main Methods:

• Retrospective analysis of 101 patients undergoing thoracoscopic anatomical lung resections by residents with ≤50 cases of experience.
• Comparison of patient and surgical factors between patients with and without complications.
• Logistic regression analysis to determine significant risk factors for postoperative complications.

Main Results:

• Complications occurred in 27.7% of patients, primarily prolonged air leaks.
• Significant univariable risk factors included age ≥76 years, heavy smoking, extensive adhesions, longer operative time, and use of ≥6 staplers.
• Multivariable analysis confirmed age ≥76 years and use of ≥6 staplers as consistent significant risk factors. No complications were observed with operative time <180 min.

Conclusions:

• Meticulous patient selection is essential for trainee residents to mitigate risks.
• Avoiding high-risk cases, characterized by identified factors, can enhance patient safety and optimize surgical training outcomes.