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Clinical impact of Endoscopic Surgical Skill Qualification System (ESSQS) by Japan Society for Endoscopic Surgery (JSES) for laparoscopic distal gastrectomy and low anterior resection based on the National Clinical Database (NCD) registry

AIM: This study aimed to evaluate the association between surgeons certified via the Endoscopic Surgical Skill Qualification System (ESSQS) of the Japan Society for Endoscopic Surgery (JSES) and surgical outcomes of laparoscopic distal gastrectomy (LDG) and laparoscopic low anterior resection (LLAR)...

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Autores principales: Akagi, Tomonori, Endo, Hideki, Inomata, Masafumi, Yamamoto, Hiroyuki, Mori, Toshiyuki, Kojima, Kazuyuki, Kuroyanagi, Hiroya, Sakai, Yoshiharu, Nakajima, Kentaro, Shiroshita, Hidefumi, Etoh, Tsuyoshi, Saida, Yoshihisa, Yamamoto, Seiichiro, Hasegawa, Hirotoshi, Ueno, Hideki, Kakeji, Yoshihiro, Miyata, Hiroaki, Kitagawa, Yuko, Watanabe, Masahiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726689/
https://www.ncbi.nlm.nih.gov/pubmed/33319163
http://dx.doi.org/10.1002/ags3.12384
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author Akagi, Tomonori
Endo, Hideki
Inomata, Masafumi
Yamamoto, Hiroyuki
Mori, Toshiyuki
Kojima, Kazuyuki
Kuroyanagi, Hiroya
Sakai, Yoshiharu
Nakajima, Kentaro
Shiroshita, Hidefumi
Etoh, Tsuyoshi
Saida, Yoshihisa
Yamamoto, Seiichiro
Hasegawa, Hirotoshi
Ueno, Hideki
Kakeji, Yoshihiro
Miyata, Hiroaki
Kitagawa, Yuko
Watanabe, Masahiko
author_facet Akagi, Tomonori
Endo, Hideki
Inomata, Masafumi
Yamamoto, Hiroyuki
Mori, Toshiyuki
Kojima, Kazuyuki
Kuroyanagi, Hiroya
Sakai, Yoshiharu
Nakajima, Kentaro
Shiroshita, Hidefumi
Etoh, Tsuyoshi
Saida, Yoshihisa
Yamamoto, Seiichiro
Hasegawa, Hirotoshi
Ueno, Hideki
Kakeji, Yoshihiro
Miyata, Hiroaki
Kitagawa, Yuko
Watanabe, Masahiko
author_sort Akagi, Tomonori
collection PubMed
description AIM: This study aimed to evaluate the association between surgeons certified via the Endoscopic Surgical Skill Qualification System (ESSQS) of the Japan Society for Endoscopic Surgery (JSES) and surgical outcomes of laparoscopic distal gastrectomy (LDG) and laparoscopic low anterior resection (LLAR). METHODS: Japanese National Clinical Database data on the patients undergoing LDG and LLAR between 2014‐2016 were analyzed retrospectively. The proportion of cases performed by ESSQS‐certified surgeons was calculated for each procedure, and clinicopathological factors with or without participation of ESSQS‐certified surgeons as an operator were assessed. Then, effects of operations performed by ESSQS‐certified surgeons on short‐term patient outcomes were analyzed using generalized estimating equations logistic regression analysis. RESULTS: There were 110 610 and 65 717 patients who underwent LDG and LLAR, respectively. The operations performed by ESSQS‐certified surgeons in each procedure totaled 28 467 (35.3%) and 12 866 (31.2%), respectively. A multivariable logistic regression model showed that odds ratios of mortality for LDG and LLAR performed by ESSQS‐certified surgeons were 0.774 (95% CI, 0.566‐1.060, P = 0.108) and 0.977 (0.591‐1.301, P = 0.514), respectively. Odds ratios for secondary endpoints of anastomotic leakage in LDG and LLAR performed by ESSQS‐certified surgeons were 0.835 (95% CI, 0.723‐0.964, P = 0.014) and 0.929 (0.860‐1.003, P = 0.059), respectively, whereas that of ileus/bowel obstruction for LLAR performed by ESSQS‐certified surgeons was 1.265 (1.132‐1.415, P < 0.001). There were no significant associations between the two operations performed by ESSQS‐certified surgeons and other factors such as mortality and overall complications. CONCLUSIONS: ESSQS certification did not affect postoperative mortality following LDG and LLAR, but annual experience of laparoscopic surgery was associated with it. ESSQS certification may contribute to favorable outcomes regarding anastomotic leakage following LDG and LLAR.
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spelling pubmed-77266892020-12-13 Clinical impact of Endoscopic Surgical Skill Qualification System (ESSQS) by Japan Society for Endoscopic Surgery (JSES) for laparoscopic distal gastrectomy and low anterior resection based on the National Clinical Database (NCD) registry Akagi, Tomonori Endo, Hideki Inomata, Masafumi Yamamoto, Hiroyuki Mori, Toshiyuki Kojima, Kazuyuki Kuroyanagi, Hiroya Sakai, Yoshiharu Nakajima, Kentaro Shiroshita, Hidefumi Etoh, Tsuyoshi Saida, Yoshihisa Yamamoto, Seiichiro Hasegawa, Hirotoshi Ueno, Hideki Kakeji, Yoshihiro Miyata, Hiroaki Kitagawa, Yuko Watanabe, Masahiko Ann Gastroenterol Surg Original Articles AIM: This study aimed to evaluate the association between surgeons certified via the Endoscopic Surgical Skill Qualification System (ESSQS) of the Japan Society for Endoscopic Surgery (JSES) and surgical outcomes of laparoscopic distal gastrectomy (LDG) and laparoscopic low anterior resection (LLAR). METHODS: Japanese National Clinical Database data on the patients undergoing LDG and LLAR between 2014‐2016 were analyzed retrospectively. The proportion of cases performed by ESSQS‐certified surgeons was calculated for each procedure, and clinicopathological factors with or without participation of ESSQS‐certified surgeons as an operator were assessed. Then, effects of operations performed by ESSQS‐certified surgeons on short‐term patient outcomes were analyzed using generalized estimating equations logistic regression analysis. RESULTS: There were 110 610 and 65 717 patients who underwent LDG and LLAR, respectively. The operations performed by ESSQS‐certified surgeons in each procedure totaled 28 467 (35.3%) and 12 866 (31.2%), respectively. A multivariable logistic regression model showed that odds ratios of mortality for LDG and LLAR performed by ESSQS‐certified surgeons were 0.774 (95% CI, 0.566‐1.060, P = 0.108) and 0.977 (0.591‐1.301, P = 0.514), respectively. Odds ratios for secondary endpoints of anastomotic leakage in LDG and LLAR performed by ESSQS‐certified surgeons were 0.835 (95% CI, 0.723‐0.964, P = 0.014) and 0.929 (0.860‐1.003, P = 0.059), respectively, whereas that of ileus/bowel obstruction for LLAR performed by ESSQS‐certified surgeons was 1.265 (1.132‐1.415, P < 0.001). There were no significant associations between the two operations performed by ESSQS‐certified surgeons and other factors such as mortality and overall complications. CONCLUSIONS: ESSQS certification did not affect postoperative mortality following LDG and LLAR, but annual experience of laparoscopic surgery was associated with it. ESSQS certification may contribute to favorable outcomes regarding anastomotic leakage following LDG and LLAR. John Wiley and Sons Inc. 2020-08-31 /pmc/articles/PMC7726689/ /pubmed/33319163 http://dx.doi.org/10.1002/ags3.12384 Text en © 2020 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Akagi, Tomonori
Endo, Hideki
Inomata, Masafumi
Yamamoto, Hiroyuki
Mori, Toshiyuki
Kojima, Kazuyuki
Kuroyanagi, Hiroya
Sakai, Yoshiharu
Nakajima, Kentaro
Shiroshita, Hidefumi
Etoh, Tsuyoshi
Saida, Yoshihisa
Yamamoto, Seiichiro
Hasegawa, Hirotoshi
Ueno, Hideki
Kakeji, Yoshihiro
Miyata, Hiroaki
Kitagawa, Yuko
Watanabe, Masahiko
Clinical impact of Endoscopic Surgical Skill Qualification System (ESSQS) by Japan Society for Endoscopic Surgery (JSES) for laparoscopic distal gastrectomy and low anterior resection based on the National Clinical Database (NCD) registry
title Clinical impact of Endoscopic Surgical Skill Qualification System (ESSQS) by Japan Society for Endoscopic Surgery (JSES) for laparoscopic distal gastrectomy and low anterior resection based on the National Clinical Database (NCD) registry
title_full Clinical impact of Endoscopic Surgical Skill Qualification System (ESSQS) by Japan Society for Endoscopic Surgery (JSES) for laparoscopic distal gastrectomy and low anterior resection based on the National Clinical Database (NCD) registry
title_fullStr Clinical impact of Endoscopic Surgical Skill Qualification System (ESSQS) by Japan Society for Endoscopic Surgery (JSES) for laparoscopic distal gastrectomy and low anterior resection based on the National Clinical Database (NCD) registry
title_full_unstemmed Clinical impact of Endoscopic Surgical Skill Qualification System (ESSQS) by Japan Society for Endoscopic Surgery (JSES) for laparoscopic distal gastrectomy and low anterior resection based on the National Clinical Database (NCD) registry
title_short Clinical impact of Endoscopic Surgical Skill Qualification System (ESSQS) by Japan Society for Endoscopic Surgery (JSES) for laparoscopic distal gastrectomy and low anterior resection based on the National Clinical Database (NCD) registry
title_sort clinical impact of endoscopic surgical skill qualification system (essqs) by japan society for endoscopic surgery (jses) for laparoscopic distal gastrectomy and low anterior resection based on the national clinical database (ncd) registry
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726689/
https://www.ncbi.nlm.nih.gov/pubmed/33319163
http://dx.doi.org/10.1002/ags3.12384
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