Effect of the First Assistant on Anastomotic Leakage after Rectal Cancer Surgery with Double-Stapling Anastomosis: A Propensity Score Matching Analysis

被引:0
作者
Lee, Soo Young [1 ]
Lee, Sola [1 ]
Song, Ook [1 ]
Lee, Jaram [1 ]
Park, Hyeong-min [1 ]
Kim, Chang Hyun [1 ]
Kim, Hyeong Rok [1 ]
机构
[1] Chonnam Natl Univ Hwasun Hosp, Med Sch, Dept Surg, Hwasun, South Korea
关键词
Rectal cancer; Anastomotic leakage; First assistant; Circular stapler; LOW ANTERIOR RESECTION; RESIDENT EDUCATION; PATIENT OUTCOMES; IMPACT; PARTICIPATION; SAFETY;
D O I
10.1159/000525909
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Introduction: Proper handling and firing of the circular stapler are important for secure anastomosis in rectal cancer surgery. This study aimed to investigate the association between the first assistant and anastomotic leakage (AL) after rectal cancer surgery with double-stapling anastomosis. Methods: Patients with primary rectal cancer who underwent low anterior resection with double-stapling anastomosis between January 2015 and September 2019 were included. Data on clinicopathological characteristics, including the first assistant's sex and experience level, were retrospectively reviewed, and the risk factors for AL were analyzed using propensity score matching analysis. Results: Among 758 rectal cancer surgeries, residents participated in 401 (52.9%) surgeries, and fellows participated in 357 (47.1%) surgeries as first assistants. After propensity score matching (n = 650), AL occurred in 5.4% (35/650). The first assistant's experience level (resident: 5.5% vs. fellow: 5.2%, p = 0.862) and sex (male: 5.4% vs. female: 4.9%, p = 0.849) were not associated with the occurrence of AL. Male sex in patients was the only significant predictive factor for AL (odds ratio = 2.804, 95% confidence interval 1.070-7.351, p = 0.036). Discussion/Conclusion: The first assistant's sex and experience level were not associated with AL after rectal cancer surgery with double-stapling anastomosis. These findings may justify resident participation in rectal cancer surgeries in which circular staplers are used.
引用
收藏
页码:176 / 182
页数:7
相关论文
共 25 条
[1]   Impact of Fellow Versus Resident Assistance on Outcomes Following Pancreatoduodenectomy [J].
Carr, Rosalie A. ;
Chung, Catherine W. ;
Schmidt, Christian M. ;
Jester, Andrea ;
Kilbane, Molly E. ;
House, Michael G. ;
Zyromski, Nicholas J. ;
Nakeeb, Attila ;
Schmidt, C. Max ;
Ceppa, Eugene P. .
JOURNAL OF GASTROINTESTINAL SURGERY, 2017, 21 (06) :1025-1030
[2]   Resident Education in the Era of Patient Safety: A Nationwide Analysis of Outcomes and Complications in Resident-Assisted Oncologic Surgery [J].
Castleberry, Anthony W. ;
Clary, Bryan M. ;
Migaly, John ;
Worni, Mathias ;
Ferranti, Jeffrey M. ;
Pappas, Theodore N. ;
Scarborough, John E. .
ANNALS OF SURGICAL ONCOLOGY, 2013, 20 (12) :3715-3724
[3]   Participation of Colon and Rectal Fellows in Robotic Rectal Cancer Surgery: Effect on Surgical Outcomes [J].
Collins, Danielle ;
Machairas, Nikolaos ;
Duchalais, Emilie ;
Landmann, Ron G. ;
Merchea, Amit ;
Colibaseanu, Dorin T. ;
Kelley, Scott R. ;
Mathis, Kellie L. ;
Dozois, Eric J. ;
Larson, David W. .
JOURNAL OF SURGICAL EDUCATION, 2018, 75 (02) :465-470
[4]   Resident Participation in Index Laparoscopic General Surgical Cases: Impact of the Learning Environment on Surgical Outcomes [J].
Davis, S. Scott, Jr. ;
Husain, Farah A. ;
Lin, Edward ;
Nandipati, Kalyana C. ;
Perez, Sebastian ;
Sweeney, John F. .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2013, 216 (01) :96-104
[5]   Resident impact on operative duration for elective general surgical procedures [J].
Dull, Matthew B. ;
Gier, Chad P. ;
Carroll, Joseph T. ;
Hutchison, Dylan D. ;
Hobbs, David J. ;
Gawel, Jeffrey C. .
AMERICAN JOURNAL OF SURGERY, 2017, 213 (03) :456-459
[6]   THE DOUBLE STAPLING TECHNIQUE FOR LOW ANTERIOR RESECTION - RESULTS, MODIFICATIONS, AND OBSERVATIONS [J].
GRIFFEN, FD ;
KNIGHT, CD ;
WHITAKER, JM ;
KNIGHT, CD .
ANNALS OF SURGERY, 1990, 211 (06) :745-752
[7]   The Balance Between Surgical Resident Education and Patient Safety in Laparoscopic Colorectal Surgery: Surgical Resident's Performance has No Negative Impact [J].
Homma, Shigenori ;
Kawamata, Futoshi ;
Yoshida, Tadashi ;
Ohno, Yosuke ;
Ichikawa, Nobuki ;
Shibasaki, Susumu ;
Kawamura, Hideki ;
Takahashi, Norihiko ;
Taketomi, Akinobu .
SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, 2017, 27 (04) :295-300
[8]   Nomogram Prediction of Anastomotic Leakage and Determination of an Effective Surgical Strategy for Reducing Anastomotic Leakage after Laparoscopic Rectal Cancer Surgery [J].
Kim, Chang Hyun ;
Lee, Soo Young ;
Kim, Hyeong Rok ;
Kim, Young Jin .
GASTROENTEROLOGY RESEARCH AND PRACTICE, 2017, 2017
[9]   The Impact of Incorporating of a Novice Assistant Into a Laparoscopic Team on Operative Outcomes in Laparoscopic Sigmoidectomy: A Prospective Study [J].
Kim, Young Wan ;
Min, Byung Soh ;
Kim, Nam Kyu ;
Kim, Jeong Yeon ;
Hur, Hyuk ;
Lee, Kang Young ;
Sohn, Seung Kook ;
Cho, Chang Hwan .
SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, 2010, 20 (01) :36-41
[10]   Ergonomic evaluation of a mechanical anastomotic stapler used by Japanese surgeons [J].
Kono, Emiko ;
Tada, Mitsunori ;
Kouchi, Makiko ;
Endo, Yui ;
Tomizawa, Yasuko ;
Matsuo, Tomoko ;
Nomura, Sachiyo .
SURGERY TODAY, 2014, 44 (06) :1040-1047