Evaluation of the advantage of surgeons certified by the endoscopic surgical skill qualification system participating in laparoscopic low anterior rectal resection

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Annals of Gastroenterological Surgery Pub Date : 2023-12-14 DOI:10.1002/ags3.12763
Naruhiko Sawada, Tomonori Akagi, Manabu Shimomura, Yukitoshi Todate, Kunihiko Nagakari, Hiroaki Takeshita, Satoshi Maruyama, Manabu Takata, Nobuki Ichikawa, Koya Hida, Hiroaki Iijima, Shigeki Yamaguchi, Akinobu Taketomi, Takeshi Naitoh, The EnSSURE Study Group Collaboratives in Japan Society of Laparoscopic Colorectal Surgery.
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Abstract

Background

A technical qualification system was developed in 2004 by the Japan Society for Endoscopic Surgery. An analysis of the EnSSURE study on 3188 stage II–III rectal cancer patients, which was performed by including the participation of qualified surgeons as assistants and advisers without restricting their participation as operators, revealed that the participation of technically qualified surgeons in surgery improved the technical and oncological safety of laparoscopic rectal resection.

Aim

This secondary retrospective analysis of the EnSSURE study examined the advantage of qualified surgeons participating in laparoscopic low anterior resection (LAR).

Methods

The outcomes of low anterior resection were compared between groups with and without the participation of surgeons qualified by the Endoscopic Surgical Skill Qualification System (Q and non-Q groups, respectively). We used propensity score matching to generate paired cohorts at a one-to-one ratio. The postoperative complication rate, short-term results (hemorrhage volume, operative time, number of dissected lymph nodes, open conversion rate, intraoperative complication rate, and R0 resection rate), and long-term results (disease-free survival rate, local recurrence rate, and overall survival rate) were evaluated.

Results

The frequencies of postoperative complications, anastomotic bleeding, and intraperitoneal abscess were significantly lower, the operative time was significantly shorter, the postoperative hospital stay was significantly shorter, and the number of dissected lymph nodes was higher in the Q group. No significant differences were observed in disease-free survival, local recurrence, or overall survival rate rates between the groups.

Conclusion

The participation of qualified surgeons in LAR is technically advantageous.

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评估经内窥镜手术技能资格认证系统认证的外科医生参与腹腔镜低位直肠前切除术的优势
日本内窥镜外科协会于 2004 年制定了一套技术资格制度。对 3188 名 II-III 期直肠癌患者进行的 EnSSURE 研究分析表明,技术合格的外科医生参与手术提高了腹腔镜直肠切除术的技术和肿瘤安全性。这项对 EnSSURE 研究的二次回顾性分析探讨了合格外科医生参与腹腔镜低位前路切除术(LAR)的优势。我们比较了有内镜手术技能资格系统合格外科医生参与和没有内镜手术技能资格系统合格外科医生参与的两组(分别为 Q 组和非 Q 组)低位前路切除术的结果。我们采用倾向得分匹配法,以一对一的比例生成配对队列。我们对术后并发症发生率、短期疗效(出血量、手术时间、切除淋巴结数量、开放转化率、术中并发症发生率和 R0 切除率)和长期疗效(无病生存率、局部复发率和总生存率)进行了评估。Q组术后并发症、吻合口出血和腹腔内脓肿的发生率明显降低,手术时间明显缩短,术后住院时间明显缩短,切除淋巴结的数量较多。两组的无病生存率、局部复发率和总生存率无明显差异。
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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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