Postoperative outcomes in oesophagectomy with trainee involvement

BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery

Photon number statistics of NV centre emission

Optical sources that deterministically produce single photons with a high suppression of multi-photon emission and a negligible background component are promising candidates for standard sources for quantum metrology, quantum communication and foundations of quantum mechanics. In this paper, the photon number distribution of non-classical light emitted by nitrogen vacancy (NV) centres in nano-diamonds is studied by three different experimental techniques. The photon number resolving transition edge sensor (TES) detector and the On/Off detection method are applied to determine the diagonal elements of the optical density matrix. From the data measured by the two methods the second order correlation function at time delay zero is calculated and compared with the g2(0)-values obtained by Hanbury Brown–Twiss (HBT) interferometric measurements. Among the g2(0)-values evaluated with the three techniques, we found good agreement in the results for a single photon emitter with a g2(0)-value close to zero and a multi-photon source with a g2(0)-value of approximately 0.5