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首页> 外文期刊>Surgical Endoscopy >Introduction of laparoscopic low anterior resection for rectal cancer early during residency: a single institutional study on short-term outcomes.
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Introduction of laparoscopic low anterior resection for rectal cancer early during residency: a single institutional study on short-term outcomes.

机译：住院早期直肠癌的腹腔镜低位前切除术的引入：短期结果的单一机构研究。

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BACKGROUND: Laparoscopic surgery for rectal cancer is unpopular because it is technically challenging. Suitable training systems have not been widely studied or established despite the steep learning curve for this procedure. We developed a systematic training program that enables resident surgeons to perform laparoscopic low anterior resection (LLAR) for rectal cancer and evaluated the safety and feasibility of this training program. METHODS: We analyzed prospectively gathered data on all LLARs for rectal cancer performed at a single center over a 7-year period. Patients were assessed for demographic characteristics, tumor characteristics, operative procedure, operative time, blood loss, conversion to open surgery, complications, time to bowel recovery, distal margin, and number of lymph nodes harvested. We compared the early surgical, oncological, and functional outcomes of LLARs performed by expert surgeons with those of LLARs performed by resident surgeons for both intraperitoneal and extraperitoneal rectal cancer. All analyses were performed on an intention-to-treat basis. RESULTS: A total of 137 patients met the inclusion criteria for this study. Of the 75 LLARs for intraperitoneal rectal cancer, 40 were performed by expert surgeons (I-E group) and 35 by resident surgeons (I-R group). Of the 62 LLARs for extraperitoneal rectal cancer, 51 were performed by expert surgeons (E-E group) and 11 by resident surgeons (E-R group). The operative time was longer in the E-R group than in the E-E group. The time to resumption of diet was longer in the I-E group than in the I-R group. The other early outcomes, including blood loss, anastomotic leakage, conversion to open surgery, and number of lymph nodes harvested, were similar in the I-E and I-R groups and in the E-E and E-R groups. CONCLUSION: Our systematic training program on LLAR for rectal cancer enables resident surgeons to perform this procedure safely early during residency, with acceptable short-term outcomes.
机译：背景：腹腔镜手术治疗直肠癌是不受欢迎的，因为它在技术上具有挑战性。尽管此过程的学习曲线很陡，但尚未广泛研究或建立合适的培训系统。我们制定了系统的培训计划，使住院医师能够对腹腔镜手术进行直肠癌低位前切除术（LLAR），并评估了该培训计划的安全性和可行性。方法：我们分析了在7年期间在单个中心进行的直肠癌所有LLAR的前瞻性收集数据。评估患者的人口统计学特征，肿瘤特征，手术程序，手术时间，失血量，开腹手术的转化率，并发症，肠恢复时间，远端切缘和收集的淋巴结数目。我们比较了腹腔内和腹膜外直肠癌的专家外科医生对LLARs的早期手术，肿瘤学和功能结局与住院医师对LLARs的早期手术，肿瘤学和功能结局。所有分析均按意向性进行。结果：共有137名患者符合本研究的纳入标准。在用于腹膜内直肠癌的75个LLAR中，有40个由专业外科医生（I-E组）执行，有35个由常驻外科医生（I-R组）执行。在用于腹膜外直肠癌的62个LLAR中，有51个由专家外科医生（E-E组）执行，有11个由常驻外科医生（E-R组）执行。 E-R组的手术时间长于E-E组。 I-E组比I-R组恢复饮食的时间更长。在I-E和I-R组以及E-E和E-R组中，其他早期结果，包括失血，吻合口漏，开腹手术和收集的淋巴结数目也相似。结论：我们关于直肠癌LLAR的系统培训计划使住院医师能够在住院期间及早接受安全的短期手术，安全地进行手术。

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