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

Post-operative elevation of the neutrophil: lymphocyte ratio predicts complications following oesophageal resection

Meeting AbstractSoc Acad & Res Sur

Structures, redox behavior, antibacterial activity and correlation with electronic structure of the complexes of nickel triad with 3-(2-(alkylthio)phenylazo)-2,4-pentanedione

3-(2-(Alkylthio)phenylazo)-2,4-pentanedione (HL), an O, N, S donor ligand, is used for the synthesis of Ni(II), Pd(II) and Pt(II) complexes. The spectroscopic (IR, UV-Vis, and NMR) data determine the structure. The single crystal X-ray diffraction measurement of [Ni(L)(2)] and [Pt(L)Cl] has confirmed the structures. Coulometric oxidation of [Ni(L)(2)] and EPR spectra thereof show formation of Ni(III) state. DFT computation has calculated the electronic configuration and has explained the spectral and redox properties of the complexes. The compounds are screened for their in vitro anti-bacterial activity using Gram-positive and Gram-negative bacteria (Bacillus subtilis UC564, Escherichia coli TG1, Staphylococcus aureus Bang25, Pseudomonas aeruginosa C/1/7, Salmonella typhi NCTC62, Salmonella paratyphi NCTC A2, Shigella dysenteriae 8NCTC599/52, Streptococcus faecalis S2, Vibrio cholerae DN7 and Mricococcus luteus AGD1). The minimum inhibitory concentration is determined for the compounds. The effect of the structure of the investigated compounds on the antibacterial activity is discussed. (C) 2011 Elsevier B.V. All rights reserved.</p

Postoperative outcomes in oesophagectomy with trainee involvement

Abstract 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). Conclusions: 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