A presentation to the Society of Surgical Oncology (2023) international Conference on Surgical Cancer Care reports on a study of nearly 8000 patients who were cared for by 737 anaesthetists and 163 surgeons. It suggests that surgeons and anaesthetists who work closely together have better patient outcomes. Evidence presented suggests that for every additional procedure an anaesthetist and surgeon performed together there was a 5% reduction in the chances of a significant post-operative complication at 90 days (Clavien-Dindo grade 3-5). And whilst that association does not necessarily predict a causal relationship the findings were nevertheless powerful.
Dr Julie Hallet, an associate Professor at the University of Toronto, and her team undertook this extensive population based study of patients undergoing complex-major upper GI surgery (including oesophagectomy , pancreatectomy and liver resections) between 2007-2018. The research team focussed in specifically on the volume of procedures performed by specific surgeon-anaesthetic pairings. Having adjusted for procedure type and anaesthetic and surgical experience they were able to present a statistically significant linear relationship between the volume of operative pairings and major morbidity (P=0.01)
Dr Julie Hallet, commenting on the findings of her study, suggested that a specific ‘dynamic’ was often improved in teams who worked regularly and closely together. She has suggested that the evidence from the study could be used to encourage administrators to allow schedules to develop in a way to enhance such relationships which ultimately impacts upon patient outcomes. And whilst the study specifically concentrated on a general surgical sub-specialty field it is very likely that the results of this study will have interest across all surgical specialty fields.
