Sökning: onr:"swepub:oai:lup.lub.lu.se:74943484-65ce-44cb-871a-565fc418111a" >
Can trainees safely...
-
Pande, RupalyNew Queen Elizabeth Hospital
(författare)
Can trainees safely perform pancreatoenteric anastomosis? A systematic review, meta-analysis, and risk-adjusted analysis of postoperative pancreatic fistula
- Artikel/kapitelEngelska2022
Förlag, utgivningsår, omfång ...
Nummerbeteckningar
-
LIBRIS-ID:oai:lup.lub.lu.se:74943484-65ce-44cb-871a-565fc418111a
-
https://lup.lub.lu.se/record/74943484-65ce-44cb-871a-565fc418111aURI
-
https://doi.org/10.1016/j.surg.2021.12.033DOI
Kompletterande språkuppgifter
-
Språk:engelska
-
Sammanfattning på:engelska
Ingår i deldatabas
Klassifikation
-
Ämneskategori:for swepub-publicationtype
-
Ämneskategori:ref swepub-contenttype
Anmärkningar
-
Background: The complexity of pancreaticoduodenectomy and fear of morbidity, particularly postoperative pancreatic fistula, can be a barrier to surgical trainees gaining operative experience. This meta-analysis sought to compare the postoperative pancreatic fistula rate after pancreatoenteric anastomosis by trainees or established surgeons. Methods: A systematic review of the literature was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with differences in postoperative pancreatic fistula rates after pancreatoenteric anastomosis between trainee-led versus consultant/attending surgeons pooled using meta-analysis. Variation in rates of postoperative pancreatic fistula was further explored using risk-adjusted outcomes using published risk scores and cumulative sum control chart analysis in a retrospective cohort. Results: Across 14 cohorts included in the meta-analysis, trainees tended toward a lower but nonsignificant rate of all postoperative pancreatic fistula (odds ratio: 0.77, P =.45) and clinically relevant postoperative pancreatic fistula (odds ratio: 0.69, P =.37). However, there was evidence of case selection, with trainees being less likely to operate on patients with a pancreatic duct width <3 mm (odds ratio: 0.45, P =.05). Similarly, analysis of a retrospective cohort (N = 756 cases) found patients operated by trainees to have significantly lower predicted all postoperative pancreatic fistula (median: 20 vs 26%, P <.001) and clinically relevant postoperative pancreatic fistula (7 vs 9%, P =.020) rates than consultant/attending surgeons, based on preoperative risk scores. After adjusting for this on multivariable analysis, the risks of all postoperative pancreatic fistula (odds ratio: 1.18, P =.604) and clinically relevant postoperative pancreatic fistula (odds ratio: 0.85, P =.693) remained similar after pancreatoenteric anastomosis by trainees or consultant/attending surgeons. Conclusion: Pancreatoenteric anastomosis, when performed by trainees, is associated with acceptable outcomes. There is evidence of case selection among patients undergoing surgery by trainees; hence, risk adjustment provides a critical tool for the objective evaluation of performance.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
-
Halle-Smith, James M.New Queen Elizabeth Hospital
(författare)
-
Thorne, ThomasNew Queen Elizabeth Hospital
(författare)
-
Hiddema, LydiaNew Queen Elizabeth Hospital
(författare)
-
Hodson, JamesNew Queen Elizabeth Hospital
(författare)
-
Roberts, Keith J.New Queen Elizabeth Hospital,University of Birmingham
(författare)
-
Arshad, Ali
(författare)
-
Connor, SaxonChristchurch Hospital New Zealand
(författare)
-
Conlon, Kevin C.P.Trinity College Dublin
(författare)
-
Dickson, Euan J.Glasgow Royal Infirmary
(författare)
-
Giovinazzo, FrancescoPoliclinico Universitario Agostino Gemelli
(författare)
-
Harrison, EwenUniversity of Edinburgh
(författare)
-
de Liguori Carino, NicolaManchester University NHS Foundation Trust
(författare)
-
Hore, ToddChristchurch Hospital New Zealand
(författare)
-
Knight, Stephen R.University of Edinburgh
(författare)
-
Loveday, BenjaminRoyal Melbourne Hospital
(författare)
-
Magill, LauraUniversity of Birmingham
(författare)
-
Mirza, DariusNew Queen Elizabeth Hospital
(författare)
-
Pandanaboyana, SanjayFreeman Hospital
(författare)
-
Perry, Rita J.University of Birmingham
(författare)
-
Pinkney, ThomasUniversity of Birmingham
(författare)
-
Siriwardena, Ajith K.Manchester University NHS Foundation Trust
(författare)
-
Satoi, SoheiKansai Medical University,University of Colorado
(författare)
-
Skipworth, James
(författare)
-
Stättner, Stefan
(författare)
-
Sutcliffe, Robert P.New Queen Elizabeth Hospital
(författare)
-
Tingstedt, BobbyLund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lever-, pankreas- och gallvägskirurgi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Hepato-Pancreato-Biliary Surgery,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments(Swepub:lu)kir-bti
(författare)
-
New Queen Elizabeth HospitalUniversity of Birmingham
(creator_code:org_t)
-
PARANOIA Study Group
Sammanhörande titlar
-
Ingår i:Surgery (United States): Elsevier BV172:1, s. 319-3280039-6060
Internetlänk
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
-
Pande, Rupaly
-
Halle-Smith, Jam ...
-
Thorne, Thomas
-
Hiddema, Lydia
-
Hodson, James
-
Roberts, Keith J ...
-
visa fler...
-
Arshad, Ali
-
Connor, Saxon
-
Conlon, Kevin C. ...
-
Dickson, Euan J.
-
Giovinazzo, Fran ...
-
Harrison, Ewen
-
de Liguori Carin ...
-
Hore, Todd
-
Knight, Stephen ...
-
Loveday, Benjami ...
-
Magill, Laura
-
Mirza, Darius
-
Pandanaboyana, S ...
-
Perry, Rita J.
-
Pinkney, Thomas
-
Siriwardena, Aji ...
-
Satoi, Sohei
-
Skipworth, James
-
Stättner, Stefan
-
Sutcliffe, Rober ...
-
Tingstedt, Bobby
-
visa färre...
- Om ämnet
-
- MEDICIN OCH HÄLSOVETENSKAP
-
MEDICIN OCH HÄLS ...
-
och Klinisk medicin
-
och Kirurgi
- Artiklar i publikationen
-
Surgery (United ...
- Av lärosätet
-
Lunds universitet