PurposeThe education of surgical trainees should be based on an accurate evaluation of their surgical skill levels. In our hospital, the Objective Structured Assessment of Technical Skills (OSATS) is used for this purpose. We conducted this study to demonstrate the validity and accuracy of the OSATS for assessing surgical skills in the operating room (OR) setting.MethodsBetween January, 2007 and December, 2010, the OSATS global rating scale was used to assess several operations in which surgical trainees participated. We assessed ten surgical trainees who participated as the main surgeon or first assistant, and studied the correlation between their postgraduate year and their OSATS score.ResultsThe median score of the global rating scale for each trainee improved with each year of experience. The median scores of all trainees in postgraduate years 3, 4, and 5 were significantly different (p < 0.001 for both the main surgeon and first assistant roles; Kruskal–Wallis test).ConclusionUsing the OSATS global rating scale to assess the surgical skills of trainees in the OR was feasible and effective.

We investigated the relationship between postoperative complications and prognosis in esophageal cancer patients. Two hundred five patients with esophageal cancer were divided into three case groups. Group A (n = 100) consisted of cases without postoperative complications. Groups B (n = 58) and C (n = 47) consisted of cases with minor and major postoperative complications. The 5-year survival rates were 41.8%, 21.3%, and 20.2% in groups A, B, and C, respectively. There was a significant difference in the prognosis between groups A and B, and also between groups A and C. Any patients who died within 5 years without a relapse their cases were excluded from the study; the 5-year survival rates were 46.7%, 32.3%, and 22.5% in groups A, B, and C, respectively, with a significant difference between groups A and B. There were no significant differences between the three groups regarding the patient characteristics. These results therefore indicate that postoperative complications might contribute to a poor prognosis in cancer patients.

The epidermal growth factor receptor (EGFR) level in 56 esophageal cancer tissues was measiired hy 'ZST-EGF hinding assay to elucidate its role in tumor progression. The survival rate of patients with high EGFR level (more than 50 fmol/mg protpin) was significantly lower than that of patients with low EGFR lprel (less than 50 fmol/mg protein, P IPSS than 0.01), although a correlation hetween EGFR level and the pathologic findings was not observed. The expression nf EGF was examined immunohistnrhemirally using anti-EGF monoclonal antihody in 100 esophaxeal ranrer tiwies: EGF-positive tiimnr cells were deterted in 92.0% The immunoreactivity of EGF was classified arhitrarily into four grades arcording tn the number of stained tumor cells. The expression of EGF significantly correlated with the differentiation of esophageal squamous re11 carrinoma (P less than o m. hy chi-qqiiare test). The survival rate of patients with high EGF immunoreactivity (Grade 2 or 3) was much lower than in those with lower grade (0 or 1) tumors, (P Ipss than 0.01). Patients with hoth high EGFR level and EGF immunoreactivitv had a much worse prognosis than if hoth were low. Furthermore, the mitotic index was higher in groups with hoth high EGFR and EGF than if both were low (16.39 + 5.35 vprsiw 6.990 + 3.31). These results suggest that EGF and EGFR in the autnrrine system may play an important role in tumor progression in esophageal cnnrer and their expression could he of prognostic significance. Cnnrpr 68:142-148,1991, PIDFRMAI. GROWTH FACTOR (EGF), originally iso

Relationship between epidermal growth factor receptor (EGFR) status and various prognostic factors was investigated in 91 human breast cancer tissues. Epidermal growth factor receptor was measured by biochemical competitive binding assay using iodine 125 epidermal growth factor (125I)-EGF. The EGFR status was not correlated with axillary lymph node involvement, tumor size, stage, and histologic type, but significantly correlated with histologic grading (P less than 0.05) and lymphatic invasion (P less than 0.01). Between EGFR and estrogen receptor (ER) status, a clear inverse relationship was observed (P less than 0.01). The Ki-67-positive stained cell rate, which reveals the proportion of cycling cells, was significantly higher in EGFR-positive tumor tissues than in EGFR-negative cases. Furthermore, preliminary postoperative survey demonstrated a high tendency of recurrence rate of patients with EGFR-positive tumors as compared with those with EGFR-negative tumors. These data suggest that EGFR status may be important for the prediction of biologically high malignant potential.

In order to elucidate the efficacy in gastric surgery, we evaluated seven resected cases of a submucosal gastric tumor in which laparoscopic techniques were used. The patients consisted of 1 man and 6 women. The tumors were located in the upper, middle, and lower third of the stomach in 4, 1, and 2 cases, respectively. Three tumors were located mainly on the anterior gastric wall, 2 were on the posterior wall, and 2 were on the lesser curvature. The resected tumor size averaged 3.2 x 2.6 cm. The tumors were classified as intraluminal type (4 cases) and the extraluminal type (3 cases) according to the classification of growth type. A histopathological examination identified 4 leiomyomas, 1 leiomyosarcoma, and 4 smooth muscle tumors of indeterminate malignant potential. After a tumor resection, no recurrence of the lesions occurred during the postoperative follow-up. An extraluminal growing tumor was easily resected by the laparoscopic method without any additional procedures, and this therefore seemed to be a good indication for the laparoscopic method. In contrast, an intraluminal tumor was found to be more difficult to resect using the laparoscopic method without a companion method, e.g., intraoperative endoscopy, because of the difficulties in the detection and resection of the tumor from the serosal side. A more efficient technique must therefore be developed for this type of tumor.