Abstract
BackgroundWhile minimally invasive thoracic surgery (MIS) has increased nationwide over the years, most patients undergoing lung and esophageal resections still undergo an open approach. We performed a national survey to analyze factors associated with a propensity to perform MIS after completing a cardiothoracic training program.Materials and methodsCardiothoracic surgery trainees in 2 or 3-year programs from 2010 to 2016 were sent an online survey regarding the numbers and types of cases performed during training and current practice patterns as attending surgeons. Comfort level with MIS was also assessed. Responses were recorded and analyzed using SPSS.ResultsOne hundred thirty-six trainees responded, with a mean of 121 lobectomies (30-250) and 40 esophagectomies (8-110) performed during training. Mean minimally invasive lobectomy and esophagectomy rates during training were 53% and 30% respectively. A greater ratio of MIS procedures performed during training correlated with a higher rate performed as an attending (lobectomies, p = 0.04; esophagectomies, p = 0.01) and a greater comfort level with performing these procedures (lobectomies, p = 0.01 and esophagectomies, p < 0.01).ConclusionsBased on these results, performing a greater ratio of minimally invasive lobectomies and esophagectomies during fellowship training increases the likelihood of performing them as an attending.
Highlights
There has been a lag in adoption and full implementation of minimally invasive surgery in cardiothoracic surgery
While minimally invasive thoracic surgery has been associated with faster recovery, lower morbidity and mortality, decreased length of stay (LOS), and costs, the national utilization rate of minimally invasive approaches in thoracic surgery has remained at approximately 40% [1]
Graduates had performed an average of 121 lobectomies and 40 esophagectomies during their training (Table 1)
Summary
There has been a lag in adoption and full implementation of minimally invasive surgery in cardiothoracic surgery. A previous study reported the confidence level of recent thoracic surgery graduates to be 56% and 46% for performing minimally invasive pulmonary and esophageal operations respectively [2]. We performed a national survey to analyze factors associated with a propensity to perform MIS after completing a cardiothoracic training program. Materials and methods: Cardiothoracic surgery trainees in 2 or 3-year programs from 2010 to 2016 were sent an online survey regarding the numbers and types of cases performed during training and current practice patterns as attending surgeons. Conclusions: Based on these results, performing a greater ratio of minimally invasive lobectomies and esophagectomies during fellowship training increases the likelihood of performing them as an attending
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