Trainees as primary operators do not significantly impact perioperative complication rates in breast surgery.

Breast surgery Perioperative complications Trainees

Journal

The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
ISSN: 1479-666X
Titre abrégé: Surgeon
Pays: Scotland
ID NLM: 101168329

Informations de publication

Date de publication:
Apr 2024
Historique:
received: 30 07 2023
revised: 16 11 2023
accepted: 21 11 2023
pubmed: 18 12 2023
medline: 18 12 2023
entrez: 17 12 2023
Statut: ppublish

Résumé

There is a trend for specialist care in breast surgery resulting in fewer primary operative cases for general surgery trainees; and subsequently that trainees performing advanced oncoplastic techniques in breast surgery may negatively impact patient morbidity. We have reviewed the complication rates between Australian general surgery trainees and Breast Consultants. A retrospective analysis was performed over a 5-year period (January 2016-December 2021). The key endpoints measured were relative complication rates for consultants compared to trainees, subdivided by surgery type. Surgeries were categorised as either benign, primary breast cancer surgery or re-excision. A total of 2646 operative cases were performed with the primary operator rate for consultants 58.35 % (n = 1544) and for trainees 41.65 %% (n = 1102). The overall complication rate was 2.83 % (n = 75); the overall rate for the consultants was 2.65 % and 3.08 % for the trainees. The complication rates were not statistically significant (p = 0.59) between the two groups. The mastectomy only complication rate was higher in the consultant group with a result of 7.3 % compared to 2.8 % for the trainees however was not statistically significant (p = 0.18). The most common complication was haematoma formation for both groups. This study has demonstrated that trainees can safely perform advanced oncoplastic techniques without statistically elevated morbidity. In an era where breast surgery caseloads are increasing, but the exposure to breast surgery during training are decreasing, it is necessary to implement a practice where trainees can perform breast operations under supervision at a specialized unit.

Sections du résumé

BACKGROUND BACKGROUND
There is a trend for specialist care in breast surgery resulting in fewer primary operative cases for general surgery trainees; and subsequently that trainees performing advanced oncoplastic techniques in breast surgery may negatively impact patient morbidity. We have reviewed the complication rates between Australian general surgery trainees and Breast Consultants.
METHODS METHODS
A retrospective analysis was performed over a 5-year period (January 2016-December 2021). The key endpoints measured were relative complication rates for consultants compared to trainees, subdivided by surgery type. Surgeries were categorised as either benign, primary breast cancer surgery or re-excision.
RESULTS RESULTS
A total of 2646 operative cases were performed with the primary operator rate for consultants 58.35 % (n = 1544) and for trainees 41.65 %% (n = 1102). The overall complication rate was 2.83 % (n = 75); the overall rate for the consultants was 2.65 % and 3.08 % for the trainees. The complication rates were not statistically significant (p = 0.59) between the two groups. The mastectomy only complication rate was higher in the consultant group with a result of 7.3 % compared to 2.8 % for the trainees however was not statistically significant (p = 0.18). The most common complication was haematoma formation for both groups.
CONCLUSIONS CONCLUSIONS
This study has demonstrated that trainees can safely perform advanced oncoplastic techniques without statistically elevated morbidity. In an era where breast surgery caseloads are increasing, but the exposure to breast surgery during training are decreasing, it is necessary to implement a practice where trainees can perform breast operations under supervision at a specialized unit.

Identifiants

DOI: 10.1016/j.surge.2023.11.008 PMID: 38105134
pubmed: 38105134
pii: S1479-666X(23)00142-7
doi: 10.1016/j.surge.2023.11.008
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

121-124

Informations de copyright

Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors do not have any financial or personal conflicts of interest to declare. This research paper was not funded.

Auteurs

Linda Vu (L)

Breast Clinic, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia. Electronic address: linda.vu@health.wa.gov.au.

Chaithanya Jeganathan (C)

Breast Clinic, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia.

Kallyani Ponniah (K)

Breast Clinic, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.

Adam Ofri (A)

Breast Clinic, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; Department of Surgery, Mater Hospital, North Sydney, NSW 2060, Australia; Central Clinical School, University of Sydney, Sydney, NSW 2050, Australia; Royal Prince Alfred Hospital Institute of Academic Surgery, Camperdown, NSW 2050, Australia.

Classifications MeSH