Trainee surgeons and patient outcomes in carotid endarterectomy: a retrospective cohort study.

Abstract:

BACKGROUND:In Australia and New Zealand, more than 2000 carotid endarterectomies are performed annually. The major morbidities arising from this procedure are post-operative stroke, cranial nerve injury and death. Carotid endarterectomy surgery is a key component of the vascular surgical training programme. We assessed the impact of having a surgical trainee perform a major component of this procedure on the post-operative rates of stroke, cranial nerve injury and mortality. METHODS:We performed a retrospective cohort study of vascular surgical patients undergoing carotid endarterectomy, with data obtained from the Australasian Vascular Audit database between January 2010 and December 2014. The dataset comprised of 6528 carotid endarterectomies performed during this time. The collected data were stratified into two categories - consultant-led cases, and those in which trainee surgeons performed at least a major component of the surgery under consultant supervision. The results were analysed for differences in post-operative stroke, cranial nerve injury and inpatient mortality. Differences between groups were assessed using multivariate analysis, adjusting for potentially confounding covariables. RESULTS:On multivariate analysis, there was no statistically significant difference in the rates of post-operative stroke (odds ratio (OR) 0.88, 95% confidence interval (CI) 0.57-1.36, P = 0.55), cranial nerve injury (OR 0.68, 95% CI 0.39-1.21, P = 0.19) or inpatient mortality (OR 0.78, 95% CI 0.29-2.13, P = 0.63) between the two cohorts. CONCLUSION:Having surgical trainees perform components of carotid endarterectomies under supervision is not associated with an increased rate of post-operative stroke, cranial nerve injury or mortality.

journal_name

ANZ J Surg

journal_title

ANZ journal of surgery

authors

Johnson NW,Smoll NR,Tan C,Brooks CE

doi

10.1111/ans.16209

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

1710-1715

issue

9

eissn

1445-1433

issn

1445-2197

journal_volume

90

pub_type

杂志文章
  • Video-assisted thoracoscopic surgery versus open thoracotomy for pulmonary metastasectomy: a systematic review.

    abstract:BACKGROUND:Pulmonary metastasectomy has become a popular procedure for patients with pulmonary metastases. It can be achieved via the traditional open thoracotomy or the more recently developed video-assisted thoracoscopic surgery (VATS). However, there has been much debate as to which approach is better in terms of de...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1111/ans.12925

    authors: Cheang MY,Herle P,Pradhan N,Antippa P

    更新日期:2015-06-01 00:00:00

  • Laryngoscopic techniques to assess vocal cord mobility following thyroid surgery.

    abstract:BACKGROUND:Assessment of vocal cord mobility using Macintosh laryngoscope is frequently performed after extubation following thyroid surgery to rule out laryngeal nerve palsy. This study compared patient comfort and assessment accuracy of post-operative vocal fold mobility with Macintosh laryngoscope and fibreoptic end...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2010.05441.x

    authors: Kundra P,Kumar V,Srinivasan K,Gopalakrishnan S,Krishnappa S

    更新日期:2010-11-01 00:00:00

  • Haemorrhagic complications of pancreaticoduodenectomy.

    abstract:BACKGROUND:Haemorrhagic complication occurs in 5-16% of patients following pancreaticoduodenectomy (PD). We report an analysis of patients with post-PD bleed, to identify predictors of bleed, predictors of survival following bleed and the management of post-PD bleed. METHODS:Two hundred and eighteen patients with peri...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-1433.2004.03212.x

    authors: Balachandran P,Sikora SS,Raghavendra Rao RV,Kumar A,Saxena R,Kapoor VK

    更新日期:2004-11-01 00:00:00

  • Paediatric appendicitis: increased disease severity and complication rates in rural children.

    abstract:BACKGROUND:Appendicitis is the most common surgical emergency affecting children. Rurality has been shown to be a predictor of worse surgical outcomes in patients with acute appendicitis compared to urban residents. There are no previously published studies investigating this in Australasia. METHODS:A 10-year retrospe...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15328

    authors: Elliott BM,Witcomb Cahill H,Harmston C

    更新日期:2019-09-01 00:00:00

  • Telehealth in paediatric orthopaedic surgery in Queensland: a 10-year review.

    abstract:BACKGROUND:Telemedicine is a patient consultation method commonly available to patients in rural and remote areas throughout Australia. Its use in paediatric orthopaedics has been rarely described. The primary aim of this study was to identify the patient cohort accessing the orthopaedic paediatric telehealth service t...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.12753

    authors: Rowell PD,Pincus P,White M,Smith AC

    更新日期:2014-12-01 00:00:00

  • Can serum inflammatory parameters estimate outcome of pleurodesis in mesothelioma?

    abstract:BACKGROUND:As pleurodesis causes systemic inflammation and is associated with considerable cost and morbidity during long-term follow up, the identification of patients who will experience an unsuccessful pleurodesis would be desirable. This study was aimed to investigate whether systemic inflammatory reaction induced ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2007.04028.x

    authors: Bilgin M,Hasdiraz L,Ozkaya M,Oguzkaya F

    更新日期:2007-04-01 00:00:00

  • Clinical efficacy of middle pancreatectomy contrasts distal pancreatectomy: a single-institution experience and review of literature.

    abstract:BACKGROUND:We aim to analyse the difference of clinical efficacy between middle pancreatectomy (MP) and distal pancreatectomy (DP). METHODS:A retrospective study was used to analyse 39 cases of MP and 52 cases of DP from the Department of Hepatopancreatobiliary Surgery of the Affiliated Hospital of Qingdao University ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15095

    authors: Tan Z,Chen P,Dong Z,Zhou B,Guo WD

    更新日期:2019-05-01 00:00:00

  • Caseload distribution of general surgeons in regional Australia: is there a role for a rural surgery sub-specialization?

    abstract:BACKGROUND:Rural and regional Australia presents a unique challenge in the delivery of surgical services by virtue of its geographical vastness and low population density. While up to 33% of Australians live in rural or regional areas, only 14.8% of surgeons work in a rural or regional area. Data regarding the caseload...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.14680

    authors: Bappayya S,Chen F,Alderuccio M,Schwalb H

    更新日期:2019-06-01 00:00:00

  • Caecal bascule: a case series and literature review.

    abstract:BACKGROUND:Caecal bascule is a rare condition characterized by the inferior pole of the caecum folding on a horizontal axis antero-superiorly towards the ascending colon, potentially causing obstruction. An unusual variant of volvulus, diagnosis is challenging due to its obscurity. We present the experience of an Austr...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1111/ans.13898

    authors: Park JS,Ng KS,Young CJ

    更新日期:2018-05-01 00:00:00

  • Endoscopic cyst-gastrostomy for pancreatic pseudocysts: refining the indications.

    abstract:BACKGROUND:Pseudocysts are a common consequence of acute pancreatitis and require intervention if symptomatic. Endoscopic management is emerging as a safe and effective alternative to surgery, although its use is not yet widespread. METHODS:We describe our experience of 10 consecutive unselected patients who underwent...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.12648

    authors: Due SL,Wilson TG,Chung A,Chen JW

    更新日期:2016-05-01 00:00:00

  • Surgical procedures for melanoma in public and private New South Wales hospitals, 2001-2002.

    abstract:BACKGROUND:Evidence suggests that there is considerable variation in the types of procedures used to treat cancer. This variation may result in suboptimal or cost-ineffective care. The present study examined the variation in surgical treatment of melanoma before the establishment of a Melanoma Network that could promot...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2006.03717.x

    authors: Barton MB,Gabriel GS,Frommer MS,Holt PE,Thompson JF

    更新日期:2006-05-01 00:00:00

  • Laser tenotomy and vocal process resection for bilateral midline vocal fold fixation.

    abstract:BACKGROUND:The present retrospective study presents the outcomes of a group of 21 patients with laryngeal obstruction caused by bilateral vocal fold fixation. All of these patients were treated by laser assisted muscle tenotomy and vocal process resection - a modification of the technique described by Michael and Eugen...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1445-2197.2003.02603.x

    authors: Havas TE,Priestley KJ

    更新日期:2003-05-01 00:00:00

  • Treatment of scaphoid fractures using a memory alloy nail-feet-fixation device.

    abstract:BACKGROUND:Scaphoid fracture is a common carpal fracture, and its treatment often requires fixation devices. This study aimed to investigate the efficacy and safety of a memory alloy nail-feet-fixation (MANFF) device in treating scaphoid fractures. METHODS:Sixty-six patients with closed scaphoid fractures were treated...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.13641

    authors: Li C,Xu X,Su Y,Zhou T,Fan X,Xu Y

    更新日期:2016-07-01 00:00:00

  • Gallstones in New Zealand: composition, risk factors and ethnic differences.

    abstract:BACKGROUND:Gallstone disease is a worldwide problem causing morbidity, mortality and a drain on health-care resources. This prospective study aimed to investigate the spectrum of gallstone types in New Zealand and relate these to known risk factors. METHODS:Gallstone samples were collected from 107 patients undergoing...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2012.06234.x

    authors: Stringer MD,Fraser S,Gordon KC,Sharples K,Windsor JA

    更新日期:2013-07-01 00:00:00

  • Randomized blinded control trial into tourniquet tolerance in awake volunteers.

    abstract:BACKGROUND:The ability to tolerate a tourniquet is often the limiting factor to elective and emergent procedures of the upper limb performed under local anaesthesia. This study aims to demonstrate that upper limb tourniquets are more predictably and better tolerated when inflated to 200 mmHg than to the traditional inf...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.12532

    authors: Lim E,Shukla L,Barker A,Trotter DJ

    更新日期:2015-09-01 00:00:00

  • Feasibility of day-care open cholecystectomy: evaluation in an inpatient model.

    abstract:BACKGROUND:Open cholecystectomy is still a fairly frequently performed operation worldwide, and is used where laparoscopic surgery has failed or is contraindicated, and where some surgeons do not operate laparoscopically for technical reasons. In developing countries laparoscopic cholecystectomy is costly and is availa...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1440-1622.2001.02046.x

    authors: Thomas S,Singh J,Bishnoi PK,Kumar A

    更新日期:2001-02-01 00:00:00

  • Hartmann's reversal: a comparative study between laparoscopic and open approaches.

    abstract:BACKGROUND:A reversal of Hartmann's procedure can be performed using either a laparoscopic or open approach. However, laparoscopic reversal (LR) of Hartmann's procedure is challenging. This study was designed to compare the results between open and laparoscopic approaches. METHODS:This was a retrospective study of pro...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.13979

    authors: Kwak HD,Kim J,Kang DW,Baek SJ,Kwak JM,Kim SH

    更新日期:2018-05-01 00:00:00

  • Single-institution review of managing dermatofibrosarcoma protuberans.

    abstract:BACKGROUND:Dermatofibrosarcoma protuberans (DFSP) is a rare locally advanced soft-tissue tumour that is often misdiagnosed at presentation, resulting in inadequate initial resection, requiring multiple resections and reconstructive procedures. We reviewed our experience and treatment outcomes with this tumour and propo...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.13276

    authors: Tan YG,Chia CS,Loh WL,Teo MC

    更新日期:2016-05-01 00:00:00

  • Morbidity and mortality in cervical spine injuries in the elderly.

    abstract:BACKGROUND:The aim of our study was to identify the demographics and complications in elderly cervical spine injuries and predictive factors for surgery, complications and mortality. We hypothesized younger healthier patients were more likely to undergo surgical intervention. METHODS:A retrospective review of 225 cons...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.14875

    authors: Bokhari AR,Sivakumar B,Sefton A,Lin JL,Smith MM,Gray R,Hartin N

    更新日期:2019-04-01 00:00:00

  • Variations in intrinsic breast cancer characteristics in screen-detected breast cancer patients aged between 45 and 69 and above the age of 70.

    abstract:BACKGROUND:Increasing age is a well-recognized risk factor for breast cancer. With an increase in life expectancy of women, more older patients are diagnosed with breast cancer. This study aimed to identify the variations in breast cancer attributes and mortality in different age groups in New Zealand. METHODS:This wa...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.16430

    authors: Huang Y,Ip EC,Ng AKT,Cohen-Hallaleh R

    更新日期:2020-11-20 00:00:00

  • Nausea, vomiting and return of bowel function after colorectal surgery.

    abstract:BACKGROUND:Although patterns of return of bowel function (ROBF) following colorectal surgery with enhanced recovery after surgery (ERAS) programmes have been well delineated, regular morphine use is uncommon. This study describes the patterns of post-operative nausea and vomiting (PONV) and ROBF in this context. METHO...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.13290

    authors: Barclay KL,Zhu YY,Tacey MA

    更新日期:2015-11-01 00:00:00

  • Optimization of perioperative care for colonic surgery: a review of the evidence.

    abstract::Enhanced recovery after surgery (ERAS) care pathways are becoming increasingly common in colonic surgery. ERAS is a combination of individual strategies that have been shown to be effective in improving care. In this article, we review the evidence surrounding core components of enhanced recovery care pathways for pat...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1111/j.1445-2197.2007.04350.x

    authors: Zargar-Shoshtari K,Hill AG

    更新日期:2008-01-01 00:00:00

  • Neutrophil-to-lymphocyte ratio predicts anastomotic dehiscence.

    abstract:BACKGROUND:Anastomotic dehiscence (AD) is the most feared complication following colonic and rectal anastomosis. Multiple attempts have been made to correlate the levels of biomarkers to the risk of AD. This study attempts to compare C-reactive protein (CRP), procalcitonin (PCT) and neutrophil-to-lymphocyte ratio (NLR)...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.14369

    authors: Walker PA,Kunjuraman B,Bartolo DCC

    更新日期:2018-01-27 00:00:00

  • Laparoscopic-assisted colectomy with Duhamel procedure for idiopathic megacolon in adults: a retrospective study.

    abstract:BACKGROUND:Idiopathic megacolon (IMC) is an uncommon disease in adults. To date, only a few laparoscopic experiences and functional outcomes of IMC have been reported. This study was to retrospectively analyse our 12 year surgical experience and functional outcomes in adult patients with IMC. METHODS:A 12-year retrosp...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15868

    authors: Wang L,Zheng H,Tian Y,Mou J,Zhang L,Liu B,Tong W

    更新日期:2020-11-01 00:00:00

  • Tumour cell frequency in pleural lavage in cases with stage I epidermoid lung cancer with no visceral pleural involvement.

    abstract:BACKGROUND:The presence of tumour cells in the pleural lavage of lung cancer patients with no malignant pleural effusion is a negative prognosticator. In the present study we aimed to determine the lowest frequency of positive pleural lavage in lung cancer. METHODS:The study included 26 consecutive patients who underw...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2005.03355.x

    authors: Oguzkaya F,Akçali Y,Bilgin M,Haberal A,Akgün H

    更新日期:2005-05-01 00:00:00

  • Factors related to post-operative metabolic acidosis following major abdominal surgery.

    abstract:BACKGROUND:Metabolic acidosis is frequently observed in perioperative patients, especially those who undergo major surgery. The aim of this study was to evaluate the factors related to post-operative metabolic acidosis and to attempt to identify the clinical effect of metabolic acidosis following major abdominal surger...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2012.06235.x

    authors: Park CM,Chun HK,Jeon K,Suh GY,Choi DW,Kim S

    更新日期:2014-07-01 00:00:00

  • Colonoscopy withdrawal time and polyp/adenoma detection rate: a single-site retrospective study in regional Queensland.

    abstract:BACKGROUNDS:Bowel cancer is the second most common non-cutaneous cancer diagnosed in Australia among both genders. Colonoscopy withdrawal time of at least 6 min has been accepted as the standard to achieve the target polyp detection rate (PDR) and adenoma detection rate (ADR). A retrospective review was conducted in Bu...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15652

    authors: Wong WJ,Arafat Y,Wang S,Hawes S,Hung K

    更新日期:2020-03-01 00:00:00

  • Regional versus metropolitan pancreaticoduodenectomy mortality in Australia.

    abstract:BACKGROUND:This retrospective, population-based cohort study aims to determine if differences in the regional distribution of procedures or variation in regional mortality contributes to the variable pancreaticoduodenectomy (PD) mortality between Australian states and territories. METHODS:De-identified procedural data...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15336

    authors: Davis SS,Babidge WJ,Kiermeier A,Maddern GJ

    更新日期:2019-12-01 00:00:00

  • Splenic preservation: an additional haemostatic measure during mesh splenorrhaphy.

    abstract:BACKGROUND:Various treatment measures have been described in achieving splenic preservation following splenic injury. We describe an additional measure in achieving haemostasis during mesh splenorrhaphy. METHODS:Oxycel (BD, Franklin Lakes, NJ, USA) (topical haemostatic agent composed of oxidized cellulose) is sutured ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2004.03065.x

    authors: Reddy CG,Chalasani V,Pathma-Nathan N

    更新日期:2004-07-01 00:00:00

  • Gluteal compartment syndrome.

    abstract::Gluteal compartment syndrome is uncommon and is often diagnosed late, resulting in muscle necrosis and sciatic nerve palsy. The mainstay of treatment is prompt diagnosis and early surgery. A high index of suspicion is essential, especially in the setting of major bleeding and excessive pain. Embolization and hyperbari...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2006.03797.x

    authors: Hayden G,Leung M,Leong J

    更新日期:2006-07-01 00:00:00