TY - JOUR
T1 - Impact of the Endoscopic Surgical Skill Qualification System on the safety of laparoscopic gastrectomy for gastric cancer
AU - Shibasaki, Susumu
AU - Suda, Koichi
AU - Nakauchi, Masaya
AU - Nakamura, Kenichi
AU - Tanaka, Tsuyoshi
AU - Kikuchi, Kenji
AU - Inaba, Kazuki
AU - Uyama, Ichiro
N1 - Funding Information:
This work was not supported by any grant or funding. Acknowledgements
Funding Information:
Ichiro Uyama has received lecture fees from Intuitive Surgical, Inc., outside of the submitted work Koichi Suda, Tsuyoshi Tanaka, and Kenji Kikuchi have been funded by Medicaroid, Inc. in relation to Collaborative Laboratory for Research and Development in Advanced Surgical Technology, Fujita Health University. Koichi Suda has also received advisory fees from Medicaroid, Inc., outside of the submitted work. Susumu Shibasaki, Koichi Suda, Masaya Nakauchi, Kenichi Nakamura, Tsuyoshi Tanaka, Kenji Kikuchi, Kazuki Inaba, and Ichiro Uyama have no commercial association with or financial involvement that might pose a conflict of interest in connection with the submitted article.
PY - 2020
Y1 - 2020
N2 - Background: We hypothesized that the Endoscopic Surgical Skill Qualification System (ESSQS) can shorten operative time, resulting in a decrease in postoperative morbidity. Here, we aimed to clarify whether ESSQS-qualified surgeons could decrease the incidence of complications. Methods: Between January 2009 and June 2019, 1042 patients diagnosed with both clinical and pathological Stage ≤ III gastric cancer and undergoing LG were enrolled. In all LG procedures involving ESSQS-qualified surgeons, these served as the operator or the instructive assistant. The short-term outcomes were retrospectively compared between the ESSQS-qualified and the non-ESSQS-qualified surgeons using a propensity-score matched analysis. Results: After propensity-score matching, 321 patients were included in each group. No significant differences were observed in morbidity rate, and length of hospitalization following surgery, although the non-ESSQS-qualified surgeon group had a significantly longer total operative time (Non-ESSQS-qualified group, 368 [170–779] min vs. ESSQS-qualified group, 316 [147–772] min; p < 0.001), and larger estimated blood loss (Non-ESSQS-qualified group, 28 [0–702] mL vs. ESSQS-qualified group 25, [0–1069] mL; p = 0.042). Multivariate analysis revealed that operative time ≥ 360 min (OR 1.818 [1.069–3.094], p = 0.027) was identified as the only significant independent risk factor determining morbidity. Conclusions: The incidence of postoperative morbidity did not differ between patients operated by the qualified and nonqualified surgeons, as long as ESSQS-qualified surgeons provide intraoperative instructions.
AB - Background: We hypothesized that the Endoscopic Surgical Skill Qualification System (ESSQS) can shorten operative time, resulting in a decrease in postoperative morbidity. Here, we aimed to clarify whether ESSQS-qualified surgeons could decrease the incidence of complications. Methods: Between January 2009 and June 2019, 1042 patients diagnosed with both clinical and pathological Stage ≤ III gastric cancer and undergoing LG were enrolled. In all LG procedures involving ESSQS-qualified surgeons, these served as the operator or the instructive assistant. The short-term outcomes were retrospectively compared between the ESSQS-qualified and the non-ESSQS-qualified surgeons using a propensity-score matched analysis. Results: After propensity-score matching, 321 patients were included in each group. No significant differences were observed in morbidity rate, and length of hospitalization following surgery, although the non-ESSQS-qualified surgeon group had a significantly longer total operative time (Non-ESSQS-qualified group, 368 [170–779] min vs. ESSQS-qualified group, 316 [147–772] min; p < 0.001), and larger estimated blood loss (Non-ESSQS-qualified group, 28 [0–702] mL vs. ESSQS-qualified group 25, [0–1069] mL; p = 0.042). Multivariate analysis revealed that operative time ≥ 360 min (OR 1.818 [1.069–3.094], p = 0.027) was identified as the only significant independent risk factor determining morbidity. Conclusions: The incidence of postoperative morbidity did not differ between patients operated by the qualified and nonqualified surgeons, as long as ESSQS-qualified surgeons provide intraoperative instructions.
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U2 - 10.1007/s00464-020-08102-5
DO - 10.1007/s00464-020-08102-5
M3 - Article
AN - SCOPUS:85093835403
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
SN - 0930-2794
ER -