Effect of surgical experience on results of esophagectomy for esophageal carcinoma

J Surg Oncol. 1997 May;65(1):20-1. doi: 10.1002/(sici)1096-9098(199705)65:1<20::aid-jso4>3.0.co;2-q.


Background: Esophagectomy for esophageal cancer is associated with substantial operative morbidity and mortality. The effect of surgical experience on results of esophagectomy has received little attention in the medical literature.

Methods: A retrospective review of esophagectomies for cancer was done.

Results: Seventy-four patients underwent esophagectomy by 20 different surgeons. Three surgeons performed 6 or more esophagectomies per year ("frequent" surgeons), whereas the other 17 surgeons performed 5 or fewer esophagectomies per year ("occasional" surgeons). Forty-two patients were operated on by frequent surgeons. There were 3 (7%) anastomotic leaks and no deaths. In 32 patients operated on by occasional surgeons, there were 7 (22%) anastomotic leaks and 7 (22%) operative deaths. The anastomotic leak rates were not significantly different (P < .07), but frequent surgeons had a significantly lower operative mortality (P < .0014).

Conclusions: Esophagectomy for esophageal cancer should be performed by experienced esophageal surgeons with sufficient yearly volume of procedures to maintain competence.

MeSH terms

  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / mortality*
  • Esophagectomy / statistics & numerical data
  • Humans
  • Professional Competence
  • Retrospective Studies