Equivalent outcomes after coronary artery bypass graft surgery performed by consultant versus trainee surgeons: A systematic review and meta-analysis

Virk, Sohaib; Bowman, S.; Chan, Lionel; Bannon, Paul G.; Aty, Waleed; French, Bruce; Saxena, Akshat

doi:10.1016/j.jtcvs.2015.11.006

Cited by 20 publications

(16 citation statements)

References 35 publications

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“…Interestingly, the presence of trainees was not associated with worse mortality and all the outcomes considered in our study were similar when comparing cases done with trainees' involvement or not. These findings confirmed previously published data from the United Kingdom regarding esophageal surgery in particular and many other studies that have looked at trainee's involvement with cardiac and noncardiac surgery [21][22][23]. It is comforting that we can continue to teach complex surgeries to young trainees without compromising results.…”

Section: Commentsupporting

confidence: 87%

Influence of Specialty Training and Trainee Involvement on Perioperative Outcomes of Esophagectomy

Khoushhal

Canner

Schneider

et al. 2016

The Annals of Thoracic Surgery

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Section: Commentsupporting

confidence: 87%

Influence of Specialty Training and Trainee Involvement on Perioperative Outcomes of Esophagectomy

Khoushhal

Canner

Schneider

et al. 2016

The Annals of Thoracic Surgery

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“…Multiple studies examining non‐vascular surgery have demonstrated the safety of having trainee surgeons perform operations under supervision 7–9 . Our findings are similar to those previously published regarding the surgical training of carotid endarterectomies in Europe.…”

Section: Discussionsupporting

confidence: 89%

Trainee surgeons and patient outcomes in carotid endarterectomy: a retrospective cohort study

Johnson

Smoll

Tan

et al. 2020

ANZ Journal of Surgery

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Carotid endarterectomies are an essential part of the surgical management of embolic stroke prevention. Perioperative complication rates are pivotal in the justification of the procedure being performed. Through analysis of the Australasian Vascular Audit database, we found no significant difference in major patient morbidity or mortality in cases performed by an experienced vascular surgeon, and those cases with supervised trainees performing major components of the procedure.

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“…Performing MAG is undoubtedly technically demanding and patient's safety should always be a concern when training young surgeons. The effect of training on clinical outcome after cardiac surgery has been the subject of previous publications [14][15][16][17]. However, to the best of our knowledge, this is the first study which compared outcomes in patients undergoing CABG with MAG performed by residents versus attending surgeons and we found that the two groups had comparable short term outcomes and long term survival.…”

Section: Discussionmentioning

confidence: 64%

How Safe Is it to Train Residents to Perform Coronary Surgery With Multiple Arterial Grafting? Nineteen Years of Training at a Single Institution

Benedetto

Caputo

Gaudino

et al. 2017

Seminars in Thoracic and Cardiovascular Surgery

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The learning curve of coronary artery bypass grafting (CABG) with multiple arterial grafting (MAG) is perceived to be associated with increased surgical morbidity and potentially poorer long-term outcomes. We compared short-term outcomes and long-term survival in patients who underwent CABG with MAG performed by attending surgeons or resident trainees at a single institution over a period of 19 years. Using our institutional database, we identified 3039 patients undergoing MAG from 1996-2015. Of those, 958 (32%) were operated on by residents and 2081 (68%) by attending surgeons. Propensity score matching and mixed-effects models were used to compare the 2 groups. Operative mortality rate was 0.3% and 0.4% among patients operated by residents and attending surgeons, respectively (P = 0.71), with no significant differences among the groups in postoperative complications. After a mean follow-up time of 11 ± 4 years, survival probability at 5, 10, and 15 years was 95.1% ± 0.7% vs 96.4% ± 0.6%, 87.0% ± 1.1% vs 87.8% ± 1.1%, and 76.6.% ± 1.8% vs 77.6% ± 1.8% in the resident and attending surgeon group, respectively. Resident and attending surgeon cases showed comparable risk of death (hazard ratio [HR] = 1.01; 95% CI: 0.80-1.28; P = 0.92). The equipoise between the 2 groups was confirmed among cases receiving bilateral internal thoracic arteries only (HR = 0.88; 95% CI: 0.54-1.43; P = 0.61), radial artery (HR = 1.22; 95% CI: 0.92-1.61; P = 0.15), or their combination (HR = 0.74; 95% CI: 0.33-1.65; P = 0.47). The present analysis confirms that adequately supervised trainees can perform CABG with MAG without compromising patient safety and long-term survival.

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Equivalent outcomes after coronary artery bypass graft surgery performed by consultant versus trainee surgeons: A systematic review and meta-analysis

Cited by 20 publications

References 35 publications

Influence of Specialty Training and Trainee Involvement on Perioperative Outcomes of Esophagectomy

Influence of Specialty Training and Trainee Involvement on Perioperative Outcomes of Esophagectomy

Trainee surgeons and patient outcomes in carotid endarterectomy: a retrospective cohort study

How Safe Is it to Train Residents to Perform Coronary Surgery With Multiple Arterial Grafting? Nineteen Years of Training at a Single Institution

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