Have changes in colorectal surgery training impacted on mortality in cancer patients? A retrospective cohort study of 51,562 procedures.

IF 1.1 4区医学 Q3 SURGERY

Annals of the Royal College of Surgeons of England Pub Date : 2024-09-03 DOI:10.1308/rcsann.2024.0059

A G Taib, Z Patel, A Kler, C A Maxwell-Armstrong

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引用次数: 0

Abstract

Introduction: The aim of this study was to explore whether there were any differences in consultant colorectal surgeon training and adjusted 90-day postoperative colorectal cancer mortality rates (AMR).

Methods: We undertook a retrospective analysis of outcomes data published on the Association of Coloproctology of Great Britain and Ireland (ACPGBI) website. A total of 51,562 procedures for patients in England diagnosed with large bowel cancer between 2010 and 2015, registered under 551 consultants were included. Consultants were split into two cohorts. The first group were the pre-Calman Trained Consultants (pre-CTr), who completed their training before 1998. The second group-the post-Calman Trained Consultants (post-CTr)-included those who received their Certificate of Completion of Training (CCT) under the Calman Training Principles (CTC, 1998-2007) and the Modernising Medical Careers Curriculum (MMC, 2008 and onwards). The outcome measure was an AMR.

Results: The pre-CTr cohort (n=84) consisted of 3.6% female colorectal consultants (n=3/84), whereas the post-CTr cohort (n=467) consisted of 14.3% female colorectal consultants (n=67/467) (p=0.006). In this cross-sectional analysis over 5 years, the average pre-CTr undertook a greater number of colorectal resections than their post-CTr peers: median procedures (interquartile range, IQR): 104 (59) vs 89 (57) respectively, p=0.008. The median AMR was significantly greater among pre-CTrs compared with post-CTrs, median AMR (IQR): 2.7% (2.0) vs 2.1% (2.9), p=0.022.

Conclusions: These data indicate that the implementation of the MMC and Calman training principles for colorectal training is associated with a statistically lower AMR compared with other historical training periods. This merits further exploration.

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结直肠手术培训的变化对癌症患者的死亡率有影响吗？对 51,562 例手术的回顾性队列研究。

简介：本研究旨在探讨结直肠外科医生的培训与调整后 90 天结直肠癌死亡率（AMR）是否存在差异：本研究旨在探讨结直肠外科医生顾问培训与调整后90天结直肠癌死亡率（AMR）之间是否存在差异：我们对大不列颠及爱尔兰结直肠外科协会（ACPGBI）网站上公布的结果数据进行了回顾性分析。2010年至2015年间，英格兰共有551名顾问为确诊为大肠癌的患者进行了51562例手术。顾问分为两组。第一组是卡尔曼培训前顾问（pre-CTr），他们在1998年之前完成培训。第二组是后卡尔曼培训顾问（post-CTr），包括根据卡尔曼培训原则（CTC，1998-2007 年）和医学职业现代化课程（MMC，2008 年及以后）获得培训结业证书（CCT）的顾问。结果以AMR为衡量标准：CTC前队列（人数=84）中女性结直肠顾问占3.6%（人数=3/84），而CTC后队列（人数=467）中女性结直肠顾问占14.3%（人数=67/467）（P=0.006）。在这项历时 5 年的横断面分析中，CTr 前的平均结直肠切除术数量多于 CTr 后的同行：手术中位数（四分位数间距，IQR）分别为 104 (59) vs 89 (57)，P=0.008。CT前患者的中位AMR明显高于CT后患者，中位AMR（IQR）：2.7% (2.0) vs 2.1% (2.9)，P=0.022：这些数据表明，与其他历史培训期相比，在结直肠培训中实施 MMC 和 Calman 培训原则可在统计学上降低 AMR。这值得进一步探讨。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of the Royal College of Surgeons of England Medicine-Surgery

CiteScore

2.40

自引率

0.00%

发文量

316

期刊介绍： The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.