Does the Endoscopic Surgical Skill Qualification System improve patients’ outcome following laparoscopic surgery for colon cancer? A multicentre, retrospective analysis with propensity score matching

Abstract

Background This study aimed to investigate the short-term and oncological impact of the Endoscopic Surgical Skill Qualification System (ESSQS) by the Japan Society for Endoscopic Surgery on the operator performing laparoscopic surgery for colon cancer. Methods This retrospective cohort study was based on medical records from a multicentre database. A total of 417 patients diagnosed with stage II/III colon and rectosigmoid cancer treated with curative resection were divided into two groups according to whether they were operated on by qualified surgeons (Q group, n=352) or not (NQ group, n=65). Through strict propensity score matching, 98 cases (49 in each group) were assessed. Results Operative time was significantly longer in the NQ group than in the Q group (199 vs. 168 min, p=0.029). The amount of blood loss, post-operative complications, and duration of hospitalisation were similar between both groups. No mortality was observed. One conversion case was seen in the NQ group. The 3-year recurrence-free survival rate was 86.6% in the NQ group and 88.2% in the Q group, which was not statistically significant (log-rank p=0.966). Conclusion Direct operation by ESSQS-qualified surgeons contributed to a shortened operation time. Under an organised educational environment, almost equivalent safety and oncological outcomes are expected regardless of the surgeon’s qualifications.

Nomogram to predict postoperative infectious complications after surgery for colorectal cancer: a retrospective cohort study in China

“…As an indicator of the complexity and difficulty of the operation [31], our data validate previous studies that longer operation time is an independent predictor for IC [25,32,33]. Longer operation time may increase susceptibility to infection, resulting in IC development after surgery for CRC [7,25]. Blood transfusion was another independent risk factor for IC.…”

“…The inclusion criteria were (1) histologically confirmed CRC, (2) patients underwent surgery for CRC with radical resection, (3) patients had resection with a primary anastomosis without a protecting stoma, and (4) patients over 18 years old. The exclusion criteria were (1) palliative surgery, (2) with local surgical treatment (such as trans-anal endoscopic microsurgery), (3) with a stoma (such as Hartmann's procedure, abdominoperineal resection, and anastomosis with a de-functioning stoma), (4) patients less than 18 years old, (5) with emergency surgery, (6) with evidence of infection or systemic autoimmune disease before surgery, and (7) with incomplete medical data. Patient data were extracted from a prospectively maintained CRC database.…”

“…Colorectal cancer (CRC) is among the commonest malignancies worldwide [1][2][3]. Surgical resection is considered the best choice for a potentially radical cure [4][5][6][7]. Even with advances in surgical techniques and perioperative treatment in recent years, mortality and morbidity rates after CRC surgery remain considerable, mainly due to postoperative infectious complications (ICs) [8,9].…”

Predictive value of computed tomography with coronal reconstruction in right hemicolectomy with complete mesocolic excision for right colon cancers: a retrospective study

“…Right hemicolectomy can usually be performed through an open or laparoscopic approach. Some studies have shown that laparoscopic right hemicolectomy has some advantages over open hemicolectomy [ 21 – 23 ], but laparoscopic surgery requires a longer operative time and needs more practise [ 21 , 24 ]. Therefore, it is necessary to understand the anatomical structure of and relationships within the operation area before laparoscopic right hemicolectomy, especially when performed with the CME procedure.…”

Learning curve of intracorporeal anastomosis in laparoscopic colectomy for right side colon cancer: a cumulative sum analysis

“…No extracorporeal anastomosis was performed during this period. All surgeries were conducted by one laparoscopic surgeon who was a "quali ed surgeon" according to the endoscopic surgical skill quali cation system speci ed by the Japan Society for Endoscopic Surgery [11]. This surgeon was trained 3 times in intracorporeal anastomosis at dry labo and wet labo.…”