Key result
Supervised trainee colorectal resection shows no difference in mortality or survival vs a consultant surgeon.
Why the study?
Does resection performed by closely supervised trainee surgeons compromise morbidity, mortality, and survival rates compared to a consultant surgeon in patients with colorectal cancer?
Cohort (n=494)
Yes
Does resection performed by closely supervised trainee surgeons compromise morbidity, mortality, and survival rates compared to a consultant surgeon in patients with colorectal cancer?
Closely supervised surgical trainees can perform colorectal cancer resections with comparable mortality and survival outcomes to a consultant surgeon.
May support supervised trainee colorectal resections without worse outcomes; leaves open need for randomized confirmation before practice change.
BACKGROUND: The process of training surgeons in technique for resection of colorectal cancer should not compromise patient care or outcomes. The aim of this study was to compare morbidity, mortality and survival rates after resection performed by trainees with those for a consultant surgeon. METHODS: Outcomes for 150 patients operated on by a single colorectal surgeon at a private hospital were compared with those of 344 patients admitted under the same surgeon and operated on by closely supervised trainee surgeons in a public teaching hospital between 1995 and 2002. RESULTS: Co-morbidity was significantly more common in patients operated on by trainees; their American Society of Anesthesiologists grades were higher and tumours were more advanced. Of 16 postoperative complications evaluated, only respiratory and cardiac problems were significantly more common in patients operated on by trainees. There was no difference in operative mortality, local recurrence or 2-year survival rate after adjustment for age and tumour stage. CONCLUSION: Outcomes after resection for colorectal cancer did not differ between the consultant and trainees in the context of a closely supervised training programme.
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Renwick et al. (2005) conducted a cohort in Colorectal cancer (n=494). Resection by closely supervised trainee surgeons vs. Resection by a consultant surgeon was evaluated on Operative mortality, local recurrence, and 2-year survival rate. Resection of colorectal cancer by closely supervised trainees showed no difference in operative mortality, local recurrence, or 2-year survival compared to a consultant surgeon.