Steven Milman1, Thomas Ng. 1. Department of Surgery, Brown University School of Medicine, Providence, RI, USA.
Abstract
BACKGROUND: Thoracic procedures are currently performed by general and thoracic surgeons. Initial clinical outcome after training is a good measure of the quality of the surgical training received. METHODS: We examined the morbidity and mortality for pneumonectomy, lobectomy and esophagectomy during one surgeon's first 2 years of practice; we collected data prospectively. The results were based on the experience of the only dedicated thoracic surgeon (5 years of general surgery and 3 years of thoracic surgery training with certification from the Royal College of Physicians and Surgeons of Canada) at the largest tertiary care hospital of Brown University School of Medicine. RESULTS: During the 2-year period, 154 major pulmonary resections (20 pneumonectomies, 134 lobectomies) and 25 esophagectomies (18 transhiatal, 4 Ivor-Lewis, 2 thoracoabdominal, one 3-incision) were performed. Mortality for major lung resection was 1.9% (pneumonectomy 5%, lobectomy 1.5%), and morbidity was 27% (pneumonectomy 35%, lobectomy 26%). Mortality for esophagectomy was 4%, and morbidity was 36% (anastamotic leak 12%). CONCLUSIONS: These results compare favourably with clinical outcomes published from several large series. Thoracic surgical training in Canada is adequate and prepares surgeons well to perform major thoracic procedures. A database of the initial results from all graduates of thoracic surgery training in Canada is needed. Such a database could be used to compare the initial results of thoracic procedures performed by general and thoracic surgery graduates from Canada and the United States.
BACKGROUND: Thoracic procedures are currently performed by general and thoracic surgeons. Initial clinical outcome after training is a good measure of the quality of the surgical training received. METHODS: We examined the morbidity and mortality for pneumonectomy, lobectomy and esophagectomy during one surgeon's first 2 years of practice; we collected data prospectively. The results were based on the experience of the only dedicated thoracic surgeon (5 years of general surgery and 3 years of thoracic surgery training with certification from the Royal College of Physicians and Surgeons of Canada) at the largest tertiary care hospital of Brown University School of Medicine. RESULTS: During the 2-year period, 154 major pulmonary resections (20 pneumonectomies, 134 lobectomies) and 25 esophagectomies (18 transhiatal, 4 Ivor-Lewis, 2 thoracoabdominal, one 3-incision) were performed. Mortality for major lung resection was 1.9% (pneumonectomy 5%, lobectomy 1.5%), and morbidity was 27% (pneumonectomy 35%, lobectomy 26%). Mortality for esophagectomy was 4%, and morbidity was 36% (anastamotic leak 12%). CONCLUSIONS: These results compare favourably with clinical outcomes published from several large series. Thoracic surgical training in Canada is adequate and prepares surgeons well to perform major thoracic procedures. A database of the initial results from all graduates of thoracic surgery training in Canada is needed. Such a database could be used to compare the initial results of thoracic procedures performed by general and thoracic surgery graduates from Canada and the United States.
Authors: Stephen H Bailey; David A Bull; David H Harpole; Jeffrey J Rentz; Leigh A Neumayer; Theodore N Pappas; Jennifer Daley; William G Henderson; Barbara Krasnicka; Shukri F Khuri Journal: Ann Thorac Surg Date: 2003-01 Impact factor: 4.330
Authors: R J Ginsberg; L D Hill; R T Eagan; P Thomas; C F Mountain; J Deslauriers; W A Fry; R O Butz; M Goldberg; P F Waters Journal: J Thorac Cardiovasc Surg Date: 1983-11 Impact factor: 5.209
Authors: S J Swanson; H F Batirel; R Bueno; M T Jaklitsch; J M Lukanich; E Allred; S J Mentzer; D J Sugarbaker Journal: Ann Thorac Surg Date: 2001-12 Impact factor: 4.330