Is sufficient experience performing open gastrectomies necessary to start laparoscopic distal gastrectomy training?

Asian J Endosc Surg. 2021 Jul;14(3):489-495. doi: 10.1111/ases.12901. Epub 2020 Nov 24.

Abstract

Introduction: Laparoscopic gastrectomy has become a standard procedure for treatment of gastric cancer, and hence, the opportunity for trainees to perform open gastrectomies may decrease. We investigated whether laparoscopic distal gastrectomy, performed by surgical trainees without sufficient experience performing open gastrectomies, was feasible and safe.

Patients and methods: We compared short-term outcomes in patients when laparoscopic distal gastrectomies were performed by experienced trainees (ET group; n = 124) and inexperienced trainees (IT group; n = 98) from 2013 to 2019.

Results: The operation time was significantly shorter in the ET group (median time: 253 minutes vs 286 minutes, P < 0.001). The incidence of grade ≥ 2 postoperative complications did not differ significantly between the groups. In the multivariate analysis, experience performing open gastrectomies was not an independent predictor of postoperative complications.

Conclusion: Laparoscopic distal gastrectomies performed by trainees, with insufficient experience performing open gastrectomies, are as feasible and safe as that performed by ET.

Keywords: experience performing open gastrectomy; laparoscopic distal gastrectomy; trainee surgeon.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma* / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Feasibility Studies
  • Female
  • Gastrectomy* / adverse effects
  • Gastrectomy* / education
  • Gastrectomy* / methods
  • Gastrectomy* / statistics & numerical data
  • Gastroenterostomy / education
  • Gastroenterostomy / methods
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / education
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stomach Neoplasms* / surgery
  • Treatment Outcome