Takahashi Baku, Kamohara Keiji, Morokuma Hiroyuki, Amamoto Sojiro
Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga University, Saga, JPN.
Cureus. 2024 Dec 10;16(12):e75499. doi: 10.7759/cureus.75499. eCollection 2024 Dec.
Background The effect of surgeons' years of experience on the outcomes of acute type A aortic dissection (ATAAD) repair has not yet been studied. This study aimed to evaluate the association between the surgeon's years in practice and the outcomes of ATAAD repair. Methods Surgical records of ATAAD repairs performed at Saga University Hospital between 2004 and 2020 were reviewed. Surgeons were divided into two groups based on their surgical experience: late-career surgeons (LCSs) and early-career surgeons (ECSs) with ≥16 years and <16 of practice, respectively. The surgeons were designated as the primary surgeons or first assistants and grouped as follows: LCS-LCS, LCS-ECS, ECS-LCS, and ECS-ECS. Results During the study period, 25 primary surgeons performed 203 ATAAD repairs with 31 different first assistants: LCS-LCS, 50 repairs; LCS-ECS, 82 repairs; ECS-LCS, 55 repairs; and ECS-ECS, 16 repairs. The mean years in practice as a primary surgeon was 19.8 ± 3.3 for LCSs and 13.0 ± 1.8 for ECSs (p < 0.01). The unadjusted in-hospital mortality rates were 10.0%, 12.2%, 5.5%, and 6.3% for the LCS-LCS, LCS-ECS, ECS-LCS, and ECS-ECS groups, respectively (p = 0.63). Multivariable regression analysis showed that the surgeon's years of experience in practice were not a risk factor for in-hospital mortality. Furthermore, the long-term survival rate did not differ between the groups (p = 0.62). Conclusions The surgeons' years in practice had no effect on the outcomes of ATAAD repair. These investigations could aid in on-call coverage for ATAAD in medium-sized centers.
背景 外科医生的从业年限对急性A型主动脉夹层（ATAAD）修复手术结果的影响尚未得到研究。本研究旨在评估外科医生的从业年限与ATAAD修复手术结果之间的关联。方法 回顾了2004年至2020年在佐贺大学医院进行的ATAAD修复手术记录。根据手术经验将外科医生分为两组：分别为从业年限≥16年的资深外科医生（LCSs）和从业年限<16年的初出茅庐外科医生（ECSs）。外科医生被指定为主刀医生或第一助手，并分为以下几组：LCS-LCS组、LCS-ECS组、ECS-LCS组和ECS-ECS组。结果 在研究期间，25位主刀医生进行了203例ATAAD修复手术，有31位不同的第一助手：LCS-LCS组50例修复手术；LCS-ECS组82例修复手术；ECS-LCS组55例修复手术；ECS-ECS组16例修复手术。LCSs作为主刀医生的平均从业年限为19.8±3.3年，ECSs为13.0±1.8年（p<0.01）。LCS-LCS组、LCS-ECS组、ECS-LCS组和ECS-ECS组的未调整住院死亡率分别为10.0%、12.2%、5.5%和6.3%（p = 0.63）。多变量回归分析表明，外科医生的从业年限不是住院死亡率的危险因素。此外，各组之间的长期生存率没有差异（p = 0.62）。结论 外科医生的从业年限对ATAAD修复手术结果没有影响。这些研究有助于中型中心对ATAAD进行随叫随到的医疗服务。
