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Surgeon Quality Control and Standardization of D2 Lymphadenectomy for Gastric Cancer: A Prospective Multicenter Observational Study (KLASS-02-QC)

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dc.contributor.authorHan, SU-
dc.contributor.authorHur, H-
dc.contributor.authorLee, HJ-
dc.contributor.authorCho, GS-
dc.contributor.authorKim, MC-
dc.contributor.authorPark, YK-
dc.contributor.authorKim, W-
dc.contributor.authorHyung, WJ-
dc.contributor.authorKorean Laparoendoscopic Gastrointestinal Surgery Study (KLASS) Group-
dc.date.accessioned2023-01-10T00:38:47Z-
dc.date.available2023-01-10T00:38:47Z-
dc.date.issued2021-
dc.identifier.issn0003-4932-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/23811-
dc.description.abstractOBJECTIVE: To qualify surgeons to participate in a randomized trial comparing laparoscopic and open distal D2 gastrectomy for advanced gastric cancer. SUMMARY OF BACKGROUND DATA: No studies have sought to qualify surgeons for a randomized trial comparing laparoscopic and open D2 gastrectomy for advanced gastric cancer. METHODS: We conducted a multicenter prospective observational study evaluating unedited videos of laparoscopic and open D2 gastrectomy performed by 27 surgeons. Surgeons performed 3 of each laparoscopic and open distal gastrectomies with D2 lymphadenectomy for gastric cancer. Five peers reviewed each unedited video using a video assessment form. Based on experts' review of videos, a separate review committee decided surgeons as "Qualified" or "Not-qualified." RESULTS: Twelve surgeons (44.4%) were qualified on initial evaluation whereas the other 15 surgeons were not. Another 9 surgeons were finally qualified after re-evaluation. The median score for Qualified was significantly higher than Not-qualified (P < 0.001).Significant differences between Qualified and Not-qualified were noted both in operation type and in all evaluation area of surgical skill, perigastric, and extra-perigastric lymphadenectomy, although the inter-rater variability of the assessment score was low (kappa = 0.285). However, Not-qualified surgeons' scores improved upon re-evaluation of resubmitted videos.When compared laparoscopy with open surgery, median scores were similar between the 2 groups (P = 0.680). However, open gastrectomy scores for surgical skills were significantly higher than for laparoscopic surgery (P = 0.016). CONCLUSIONS: Our surgeon quality control study for gastrectomy represents a milestone in surgical standardization for surgical clinical trials. Our methods could also serve as a system for educating surgeons and assessing surgical proficiency.-
dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHClinical Competence-
dc.subject.MESHFemale-
dc.subject.MESHGastrectomy-
dc.subject.MESHHumans-
dc.subject.MESHLaparoscopy-
dc.subject.MESHLymph Node Excision-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHProspective Studies-
dc.subject.MESHQuality Control-
dc.subject.MESHRandomized Controlled Trials as Topic-
dc.subject.MESHStomach Neoplasms-
dc.subject.MESHTreatment Outcome-
dc.titleSurgeon Quality Control and Standardization of D2 Lymphadenectomy for Gastric Cancer: A Prospective Multicenter Observational Study (KLASS-02-QC)-
dc.typeArticle-
dc.identifier.pmid33064386-
dc.contributor.affiliatedAuthorHan, SU-
dc.contributor.affiliatedAuthorHur, H-
dc.type.localJournal Papers-
dc.identifier.doi10.1097/SLA.0000000000003883-
dc.citation.titleAnnals of surgery-
dc.citation.volume273-
dc.citation.number2-
dc.citation.date2021-
dc.citation.startPage315-
dc.citation.endPage324-
dc.identifier.bibliographicCitationAnnals of surgery, 273(2). : 315-324, 2021-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn1528-1140-
dc.relation.journalidJ000034932-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
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