P. E. Rothenberg1, B. D. Hughes2, I. C. Okereke1 1University Of Texas Medical Branch,Cardiothoracic Surgery,Galveston, TX, USA 2University Of Texas Medical Branch,Department Of Surgery,Galveston, TX, USA
Introduction:
~~Although the use of minimally invasive thoracic surgery has increased with time, the majority of patients undergoing lung and esophageal resections still receive an open approach. We performed a national survey to analyze factors associated with a propensity to perform minimally invasive thoracic surgery after completing a cardiothoracic training program.
Methods:
~~All cardiothoracic surgery trainees in standard 2 or 3 year programs from 2012 to 2016 were sent an online survey regarding numbers and types of cases performed during their training, current practice patterns as attending surgeons and comfort level with minimally invasive thoracic surgery. Responses were recorded and analyzed.
Results:
~~Sixty-one trainees responded. Trainees performed a mean of 113 lobectomies (30-250) during their training, with a mean minimally invasive rate of 53 percent. Trainees performed a mean of 42 esophagectomies (10-110) during training, with a mean minimally invasive rate of 29 percent. A higher percentage of minimally invasive lobectomies, compared to all lobectomies, performed during training was associated with a higher percentage of minimally invasive lobectomies performed as an attending physician (p = 0.04) and a greater comfort level with minimally invasive lobectomy (p = 0.01). A higher percentage of minimally invasive esophagectomies performed during training was associated with a higher rate of minimally invasive esophagectomies performed as an attending physician (p = 0.01) and a greater comfort level with minimally invasive esophagectomy (p < 0.01). A trainee’s overall case number did not influence their rate of adoption of minimally invasive surgery as attendings for either lobectomy (p = 0.11) or esophagectomy (p = 0.06).
Conclusion:
~~Recent graduates who performed a greater number of overall cases during their training were not more likely to adopt minimally invasive techniques as attending physicians if those cases during training were not performed minimally invasively. Identifying other factors during the early years of an attending physician’s career which make adoption of minimally invasive techniques more likely may help to increase further the overall prevalence of minimally invasive thoracic surgery nationwide.