Effect of surgical experience on results of esophagectomy for esophageal carcinoma

✍ Scribed by Miller, J. D.; Jain, M. K.; de Gara, C. J.; Morgan, D.; Urschel, J. D.

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 72 KB
• Volume: 65
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/(sici)1096-9098(199705)65:1<20::aid-jso4>3.0.co;2-q

✦ Synopsis

Background: Esophagectomy for esophageal cancer is associated with substantial operative morbidity and mortality. The effect of surgical experience on results of esophagectomy has received little attention in the medical literature. Methods: A retrospective review of esophagectomies for cancer was done.

Results: Seventy-four patients underwent esophagectomy by 20 different surgeons. Three surgeons performed 6 or more esophagectomies per year (''frequent'' surgeons), whereas the other 17 surgeons performed 5 or fewer esophagectomies per year (''occasional'' surgeons). Forty-two patients were operated on by frequent surgeons. There were 3 (7%) anastomotic leaks and no deaths. In 32 patients operated on by occasional surgeons, there were 7 (22%) anastomotic leaks and 7 (22%) operative deaths. The anastomotic leak rates were not significantly different (P < .07), but frequent surgeons had a significantly lower operative mortality (P < .0014). Conclusions: Esophagectomy for esophageal cancer should be performed by experienced esophageal surgeons with sufficient yearly volume of procedures to maintain competence.