Impact of Cardiothoracic Residents on Perioperative Outcomes in Lung Cancer Surgery

To investigate the impact of cardiothoracic residents on the quality of lung cancer surgery through a retrospective single-center cohort study.

Patients who underwent lung cancer surgery during the resident-involved period (R-Inv; 23.03-23.06) and the resident-absent period (R-Abs; 24.03-24.06) caused by the great resignation of residents in Korea were compared retrospectively. Patients who underwent combined surgical procedure or were transferred to other departments during the immediate postoperative period were excluded. The clinical outcomes between the 2 periods were compared.

The number of cardiothoracic residents was 4 per month during the R-Inv and 0 during the R-Abs. The number of lung cancer surgeries performed was 59.6% lower during the R-Abs period (356 vs 144). The clinical stage distribution did not differ between the 2 periods (stage I: 315 [88.5%] vs 129 [89.6%], P = 0.84). The operation times were not significantly different between the 2 periods (106.7 ± 63.1 vs 99.4 ± 55.3 min, P = 0.23). Notifications per patient were significantly more frequent with R-Abs (4.4 vs 7.8, P < 0.01). The length of hospital stay (6.2 ± 3.1 vs 6.3 ± 3.2 days, P = 0.57) and overall complication rates (18.0% vs 20.1%, P = 0.66) were similar. The total hospital costs were not significantly different ($10 334 ± $5183 vs $10 433 ± $3890, P = 0.67), but the cost for the test was 15.4% lower during the R-Abs ($948 ± $715 vs $800 ± $746, P = 0.04).

The quality of care in lung cancer surgery was similar, regardless of the involvement of cardiothoracic residents. The goal of training cardiothoracic residents can be achieved without compromising the quality of care during lung cancer surgery.