Repair of Oseophageal atrisia by consultants and supervised trainees results in similar outcomes

Abstract

Aims: consultants and trainees require exposure to complex cases for maintainingand gaining operative experience. Oesophageal atresia (OA) repair is a neonatalsurgical case with indicative numbers for completion of training. A conflict of interestmay exist between adequate training, maintaining consultant experience andachieving good outcomes. We aimed to review outcomes of cases performedprimarily by trainees compared to those by a consultant.

Methods: retrospective casenote review of all consecutive infants who underwentsurgical repair of OA with distal Tracheo-Oesophageal Fistula (TOF) between Jan1994 and Dec 2014. Only cases that underwent primary oesophageal anastomosiswere included. Surgical Outcomes were compared between cases that had trainee orconsultant listed as primary operator.

Results:one hundred and twenty-two cases were included. Fifty-two cases were operated by a trainee, 68 by a consultant (2 cases undeterminable and excluded). Infant demographics, clinical characteristics and duration of f ollow-up were similarbetween groups. All infants survived to discharge. C ases operated by a trainee andconsultant as primary operator had a similar incidence of postoperative pneumothorax (trainee 4 vs consultant 3; p=0.46), anastomotic leak (5vs 3; p=0.29) and recurrentTOF (0vs 2; p=0.5). Overall 52% of cases had an anastomotic dilatation during follow-up with no difference between trainee and consultant groups (50%vs 53%;p=0.85).

Conclusion: surgical outcomes for repair of OA/TOF are not adversely affected by trainee operating. Trainees with a ppropriate skills should perform supervised OA/TOF repair. These data are important for understanding the inter-relationship between provision of training and surgical outcomes

More information

Identifiers

ORCID for Nigel Hall: orcid.org/0000-0001-8570-9374

Catalogue record

Export record

Altmetrics