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

Potenciar los procesos de lectura y escritura en los ni?os y ni?as de primero, a trav?s de experiencias significativas.

114 p. Recurso Electr?nicoEl presente proyecto titulado ?Potenciar la lectura y escritura en los ni?os y ni?as de primero, a trav?s de experiencias significativas?, fue implementado en el Instituto T?cnico Marillac, sede rural el ?bito del municipio de Santa Rosa de Cabal; el cual tuvo como prop?sito resignificar las practicas pedag?gicas para fortalecer los procesos de lectura y escritura por medio de cuatro ejes de trabajo: la exploraci?n del medio, el juego, el arte y la literatura. De esta forma, tambi?n se potenci? las dimensiones de desarrollo de los ni?os y ni?as, tales como: personal, ?tica y valores, est?tica, comunicativa, cognitiva, espiritual y corporal; as? como las competencias ciudadanas, cient?ficas, matem?ticas y comunicativas. Este proyecto, se realiz? con la metodolog?a de investigaci?n - acci?n- participaci?n, el cual tiene como estrategia metodol?gica reconocer los intereses y necesidades de los educandos y a partir de ?stos generar propuestas creativas que permitan fortalecer y potenciar el desarrollo de los ni?os y ni?as. Palabras claves: lectura, escritura, pr?cticas pedag?gicas, experiencias significativas, exploraci?n del medio, juego, arte, literatura, dimensiones de desarrollo, competencias.The present Project entitled ?Potentiate lecture and writing among the boys and girls of first grade, through significant experiences?, it was implemented in the Technique Institute Marillac, rural headquarters the ?bito of the municipality of Santa Rosa de Cabal; which had as purpose resignificate the teaching practices to fortify the process of lecture and reading through the four work axis: the exploration of the habitat, the game, the art and literature. This way, also potentiate the dimensions of the boys and girls development, such as: personal, ethics and values, stetic, communicative, cognitive, spiritual and bodily; just like the citizen competitions, science, math and communicative. This project, was develop with the investigation methodology ? action ? participation, which has a methodology strategic to recognize the interests and needs of the teachers and from this point, generate creative proposals that allows fortify and potentialize the progress on boys and girls. Keywords: Lecture, writing, teaching practices, significant experiences, exploration of the habitat, games, arte, literature, dimensions of develop, competences