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ヤマグチ シゲキ
YAMAGUCHI Shigeki
山口 茂樹 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Usefulness of participation of endoscopic surgical skill qualification system-qualified surgeons in laparoscopic high anterior resection |
| 掲載誌名 | 正式名：Asian journal of endoscopic surgery 略 称：Asian J Endosc Surg ISSNコード：17585910/17585902 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 18(1),pp.e13409 |
| 著者・共著者 | SAWADA Naruhiko, MUKAI Shumpei, AKAGI Tomonori, OKAMOTO Ken, FUJITA Fumihiko, SUWA Hirokazu, IDE Yoshihito, FURUHATA Tomohisa, KANAZAWA Akiyoshi, SHIMAMURA Tsukasa, KOJIMA Shigehiro, OHNUMA Shinobu, KINJO Tatsuya, ICHIKAWA Nobuki, YAMAGUCHI Shigeki, TAKETOMI Akinobu, NAITOH Takeshi |
| 発行年月 | 2025/01 |
| 概要 | INTRODUCTION:A technical qualification system was established by the Japanese Society of Endoscopic Surgery in 2004, and its effectiveness in low anterior resection (LAR) has been reported. We herein performed a subgroup analysis of the effectiveness of the participation of technically qualified surgeons in laparoscopy-assisted high anterior resection (HAR), a procedure used for the technical qualification of surgeons.METHODS:The EnSSURE study enrolled 3188 patients who underwent laparoscopic rectal resection for rectal cancer between January 2014 and December 2016 at 56 Japanese hospitals. The outcomes of HAR were compared between groups with and without the participation of technically qualified surgeons. The background of the two groups were equalized by propensity score matching.RESULTS:In the group with the participation of qualified surgeons, the operative time was significantly shorter (p = .0427), more lymph nodes were dissected (p = .0207), and the conversion rate to open surgery was lower (p = .0016); however, no significant difference was observed in blood loss (p = .0616), the R0 resection rate (p = 1.00), intraoperative complication rate (p = .160), postoperative complication rate (p = 1.00), or reoperation rate (p = .6999) between the two groups. Furthermore, no significant difference was noted in long-term outcomes (recurrence-free survival (p = .275) or overall survival (p = .941)).CONCLUSIONS:In HAR, the technical benefits of the participation of qualified surgeons was limited to a shorter operative time and lower conversion rate. Nevertheless, the qualification is unique in that it predicts the usefulness of reducing complications in more technically challenging procedures when its effectiveness in LAR is considered. |
| DOI | 10.1111/ases.13409 |
| PMID | 39575540 |