Impact of the Endoscopic Surgical Skill Qualification System on the safety of laparoscopic gastrectomy for gastric cance
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and Other Interventional Techniques
Impact of the Endoscopic Surgical Skill Qualification System on the safety of laparoscopic gastrectomy for gastric cancer Susumu Shibasaki1 · Koichi Suda1,2 · Masaya Nakauchi1 · Kenichi Nakamura1 · Tsuyoshi Tanaka2 · Kenji Kikuchi2 · Kazuki Inaba1 · Ichiro Uyama1 Received: 24 June 2020 / Accepted: 15 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract 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 ESSQSqualified 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 0.1 reflected a meaningful imbalance [18].
Statistical analysis All analyses were performed using IBM SPSS Statistics 23 (IBM Corporation, Armonk, NY, USA). Between-group comparisons were examined by the χ2 test or the Mann–Whitney U test. Univariate χ2 test and multivariate logistic regression analysis were used to determine the factors contributing to the occurrence of postoperative complications. Data were expressed as medians [range] or odds ratio (OR) [95% confidence interval] unless otherwise noted. A probability (p) value
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