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
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Specialty-Certified Colorectal Surgeons Demonstrate Favorable Short-term Surgical Outcomes for Laparoscopic Low Anterior Resection: Assessment of a Japanese Nationwide Database
掲載誌名	正式名：Diseases of the colon and rectum 略　 称：Dis Colon Rectum ISSNコード：15300358/00123706
掲載区分	国外
巻・号・頁	66(12),pp.e1217-e1224
著者・共著者	YAMAGUCHI Shigeki, ENDO Hideki, YAMAMOTO Hiroyuki, MORI Toshiyuki, MISAWA Takeyuki, INOMATA Masafumi, MIYATA Hiroaki, KAKEJI Yoshihiro, KITAGAWA Yuko, WATANABE Masahiko, SAKAI Yoshiharu
担当区分	筆頭著者,責任著者
発行年月	2023/12
概要	BACKGROUND:There are few studies on the impact of a colorectal-specific technically certified surgeon on good surgical outcomes for laparoscopic low anterior resection in the real world.OBJECTIVE:To evaluate the short-term outcomes of laparoscopic low anterior resection with the participation of a certified colorectal surgeon.DESIGN:This was a retrospective cohort study using a Japanese nationwide database.SETTING:This study was conducted as a project for the Japan Society of Endoscopic Surgery and the Japanese Society of Gastroenterological Surgery.PATIENTS:This study included 41,741 patients listed in the National Clinical Database who underwent laparoscopic low anterior resection performed by certified, noncertified, and colorectal-specific certified surgeons, according to the Endoscopic Surgical Skill Qualification System, from 2016 to 2018.MAIN OUTCOME MEASURES:Operative mortality rate and anastomotic leak rate were the primary outcome measures.RESULTS:Overall 30-day mortality and operative mortality were 0.2% and 0.3%, respectively, without significant differences between all kinds of certified and noncertified surgeon groups. Overall anastomotic leak rate was 9.3%, with a significant difference between the 2 groups. Colorectal- and stomach-certified groups had lower 30-day mortality and operative mortality than the biliary-certified and noncertified groups. The anastomotic leak rate was the lowest in the colorectal-certified group. Based on a logistic regression analysis using the risk-adjusted model, operative mortality was significantly higher in the biliary-certified group than in the colorectal-certified group. Moreover, anastomotic leak rate was significantly lower in the colorectal-certified group than in the stomach-certified and noncertified groups.LIMITATIONS:This study was a retrospective study, and there was a possibility of different definitions of anastomotic leak due to the use of a nationwide database.CONCLUSIONS:The participation of a colorect
DOI	10.1097/DCR.0000000000002952
PMID	37695677