Abstract
BACKGROUND: Oesophagectomy is a complex procedure, demanding a high degree of surgeon and institutional expertise. Many health systems globally have centralised oesophagectomy services to optimise patient outcomes. Australia and Aotearoa New Zealand have relatively small populations and face unique geographical and economical challenges for centralisation of care, resulting in multiple centres performing fewer procedures. This has implications for training and maintenance of skill among surgeons. The aim of this study is to assess training, workload and current practices among Australian and Aotearoa New Zealand oesophageal surgeons, for comparison to international data. METHODS AND RESULTS: An online survey was sent to surgeons through multiple means - A total of 59 complete responses were received. Majority of respondents performed < 10 oesophagectomies in 2023 (n = 35/59; 59%), while 90% of hospitals amongst respondents performed < 30 oesophagectomies (n = 53/59). Similar rates of minimally invasive and robotic-assisted surgery were observed; however minimally invasive surgery was more common among surgeons with < 10yrs practice compared to those with > 10yrs (p = 0.016). Robot-assisted surgery was only performed by 16% of respondents; access to robotic platforms and training the largest reported barrier. Intraoperative surgical techniques and preferences were comparable to international data. CONCLUSION: Overall, the study demonstrated contemporary oesophagectomy practices among Australian and Aotearoa New Zealand surgeons when compared with international practices. With continuous growth of minimally invasive and robotic-assisted surgery, early-career oesophageal surgeons must remain up to date with emerging technologies and practices to maintain optimal patient care.