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Accreditation as a qualified surgeon improves surgical outcomes in laparoscopic distal gastrectomy

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Abstract

Purpose

The Endoscopic Surgical Skill Quantification System for qualified surgeons (QSs) was introduced in Japan to improve surgical outcomes. This study reviewed the surgical outcomes after initial experience performing laparoscopic distal gastrectomy (LDG) and evaluated the improvement in surgical outcomes following accreditation as a QS.

Methods

Eighty-seven consecutive patients who underwent LDG for gastric cancer by a single surgeon were enrolled in this study. The cumulative sum method was used to analyze the learning curve for LDG. The surgical outcomes were evaluated according to the two phases of the learning curve (learning period vs. mastery period) and accreditation (non-QS period vs. QS period).

Results

The learning period for LDG was 48 cases. Accreditation was approved at the 67th case. The operation time and estimated blood loss were significantly reduced in the QS period compared to the non-QS period (230 vs. 270 min, p < 0.001; 20.5 vs. 59.8 ml, p = 0.024, respectively). Furthermore, the major complication rate was significantly lower in the QS period than in the non-QS period (0 vs. 10.6%, p = 0.044).

Conclusions

Experience performing approximately 50 cases is required to reach proficiency in LDG. After receiving accreditation as a QS, the surgical outcomes, including the complication rate, were improved.

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Acknowledgements

This work was supported by JSPS Early Career Scientists, Grant number 18K16362.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Satoru Kikuchi, Shinji Kuroda, Masahiko Nishizaki, Nobuo Takata, Ryohei Shoji, Yoshihiko Kakiuchi, Yuzo Umeda, Kazuhiro Noma, Shunsuke Kagawa & Toshiyoshi Fujiwara

  2. Department of Gastroenterological Surgery, Shikoku Cancer Center, Matsuyama, 791-0280, Japan

    Tetsuya Kagawa

  3. Department of Surgery, Okayama Red Cross Hospital, Okayama, 700-8607, Japan

    Kazuya Kuwada

  4. Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, 700-8558, Japan

    Toshiharu Mitsuhashi

Authors
  1. Satoru Kikuchi
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  2. Tetsuya Kagawa
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  3. Shinji Kuroda
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  4. Masahiko Nishizaki
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  5. Nobuo Takata
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  9. Toshiharu Mitsuhashi
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  10. Yuzo Umeda
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  11. Kazuhiro Noma
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  12. Shunsuke Kagawa
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  13. Toshiyoshi Fujiwara
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Corresponding author

Correspondence to Satoru Kikuchi.

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The authors declare that they have no conflicts of interest for this study.

Ethical statement

The study was approved by the Institutional Review Board of Okayama University Hospital (No. 2101-021) and Shikoku Cancer Center (Rin2020-92). The research reported in this paper was in compliance with the Declaration of Helsinki.

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Kikuchi, S., Kagawa, T., Kuroda, S. et al. Accreditation as a qualified surgeon improves surgical outcomes in laparoscopic distal gastrectomy. Surg Today 51, 1978–1984 (2021). https://doi.org/10.1007/s00595-021-02309-2

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  • DOI: https://doi.org/10.1007/s00595-021-02309-2

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