Impact of Surgeon Experience on Clinical Outcomes in Cardiovascular Surgery: A Retrospective Analysis

Yıl 2025, Cilt: 10 Sayı: 1, 82 - 88

Muhammet Fethi Sağlam , Emrah Uğuz , Kemal Erdoğan , Hüseyin Ünsal Erçelik , Murat Yücel , Erol Sener

https://doi.org/10.26453/otjhs.1623206

Öz

Objective: This study aimed to assess the impact of surgeons' experience (10–20 years vs. over 20 years) on clinical outcomes in coronary artery bypass grafting (CABG) surgeries, considering the multidisciplinary nature of cardiovascular surgery and the critical role of experience in influencing mortality, morbidity, and complications.
Materials and Methods: A retrospective analysis was conducted, including 201 patients who underwent elective or emergency CABG between 2019 and 2024 at a single tertiary center. Patients were grouped based on the experience level of their surgeons. Demographic, intraoperative, and postoperative data were collected from hospital records.
Results: Patients operated on by surgeons with over 20 years of experience had significantly higher rates of hypertension (83% vs. 70.3%; p=0.033) but showed no significant differences in mortality (3% vs. 2%; p=0.170) or complication rates (7% vs. 9.9%; p=0.460). Intraoperative parameters, such as cross-clamp time and cardiopulmonary bypass time, did not differ significantly between the groups (p>0.05). Weak positive correlations were found between cross-clamp time and postoperative ICU stay (r=0.189; p=0.007), as well as cardiopulmonary bypass time and ICU stay (r=0.205; p=0.003).
Conclusions: Surgeons' experience levels influence certain clinical outcomes, particularly in managing high-risk patients. However, mortality and complication rates appear to depend more on multidisciplinary care and standardized protocols than on individual experience. Future studies should explore these dynamics across broader patient populations and different surgical procedures to optimize cardiovascular surgical practices.

Anahtar Kelimeler

Clinical outcomes, coronary artery bypass grafting, cardiovascular surgery, retrospective study, surgeon experience

Kardiyovasküler Cerrahide Cerrah Deneyiminin Klinik Sonuçlar Üzerindeki Etkisi: Retrospektif Bir Analiz

Öz

Amaç: Bu çalışmada, kardiyovasküler cerrahinin multidisipliner doğası ve deneyimin mortalite, morbidite ve komplikasyonları etkilemedeki kritik rolü göz önünde bulundurularak, koroner arter bypass greftleme (KABG) ameliyatlarında cerrahların deneyiminin (10-20 yıl ve 20 yıldan fazla) klinik sonuçlar üzerindeki etkisinin değerlendirilmesi amaçlanmıştır.
Materyal ve Metot: Tek bir üçüncü basamak merkezde 2019-2024 yılları arasında elektif veya acil KABG uygulanan 201 hastayı içeren retrospektif bir analiz yapılmıştır. Hastalar, cerrahlarının deneyim düzeyine göre gruplandırıldı. Demografik, intraoperatif ve postoperatif veriler hastane kayıtlarından toplanmıştır.
Bulgular: Yirmi yıldan fazla deneyime sahip cerrahlar tarafından ameliyat edilen hastalarda hipertansiyon oranları anlamlı derecede yüksekti (%83'e karşı %70,3; p=0,033) ancak mortalite (%3'e karşı %2; p=0,170) veya komplikasyon oranlarında (%7'ye karşı %9,9; p=0,460) anlamlı bir fark yoktu. Kros-klemp süresi ve kardiyopulmoner bypass süresi gibi intraoperatif parametreler gruplar arasında anlamlı farklılık göstermemiştir (p>0,05). Kros-klemp süresi ile ameliyat sonrası YBÜ'de kalış süresi (r=0,189; p=0,007) ve kardiyopulmoner baypas süresi ile YBÜ'de kalış süresi (r=0,205; p=0,003) arasında zayıf pozitif korelasyon bulundu.
Sonuç: Cerrahların deneyim düzeyleri, özellikle yüksek riskli hastaların yönetiminde belirli klinik sonuçları etkilemektedir. Bununla birlikte, mortalite ve komplikasyon oranları bireysel deneyimden ziyade multidisipliner bakım ve standartlaştırılmış protokollere bağlı görünmektedir. Gelecekteki çalışmalar, kardiyovasküler cerrahi uygulamalarını optimize etmek için bu dinamikleri daha geniş hasta popülasyonlarında ve farklı cerrahi prosedürlerde araştırmalıdır.

Anahtar Kelimeler

Kardiyovasküler cerrahi, klinik sonuçlar, koroner arter baypas greftleme, retrospektif çalışma, cerrah deneyimi

Kaynakça

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