Brazilian airway surgery survey indicates low overall numbers and need for improved teaching skills

Abstract

Abstract OBJECTIVES The Brazilian Society of Thoracic Surgeons (BSTS) conducted an on-line survey to determine the number of surgeons that perform adult and paediatric airway surgery, and to understand the practice patterns along the country. METHODS Active members were electronically invited to complete the questionnaire through the REDCapR platform. Invitations were sent from January to April 2020. The survey encompassed 40 questions that explored 4 different topics in the assessment of tracheal diseases: (1) Surgeon`s Demography; (2) Institutional profile, (3) Education and training in laryngo-tracheal surgery, (4) Preoperative and post operative evaluation. RESULTS Eighty-nine % of the responders declared to perform tracheal surgery with a median of 5 tracheal resection procedures per year(IQR 3–12). Interaction with other specialties occurs in 37.3% of cases. Access to technology and devices is highly variable across the country. Resident training in airway surgery consists in traditional lectures in 97% of the cases. Training in animals(15.2%), cadavers(12.1%) and simulators(6.1%) are rare. Pre-operatory evaluation encompasses flexible bronchoscopy (97.8%) and/or CT scan of the airways (90.6%). Swallowing(20.1%) and voice(14.4%) disorders are rarely evaluated. Eighty nine % of the surgeons consider bronchoscopy to be the pre-operatory gold-standard exam, followed by CT scan (38.8%) and CT-3D reconstruction (37.4%). CONCLUSIONS Brazilian surgeons refer that airway resection and reconstruction is part of their current practice, but the total number of procedures per surgeon per year is low. Access to high-end technology and equipment is heterogenous. Training offered to residents in most academic institutions relies on traditional lectures.