Impact of the English National Training Programme for laparoscopic colorectal surgery on training opportunities for senior colorectal trainees

Hemandas, Anil; Zeidan, Shady; Flashman, Karen; Khan, Jim; Parvaiz, Amjad

doi:10.1007/s00464-011-2131-1

Cited by 4 publications

(3 citation statements)

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“…The outreach training model was the only approach adopted in this study, as it was requested by the NTP trainees and agreed with the NTP trainer. The outreach model has its advantages, including minimizing the negative effect on training opportunities for surgical trainees at the NTP trainer's site, but a study by Hemandas et al [24] demonstrated that the NTP inreach model may not have a negative impact on the training of surgical trainees in their unit. An additional benefit of the outreach training model is the informal training of all theatre staff and anaesthetists in their own environment.…”

Section: Discussionmentioning

confidence: 99%

Outreach training model for accredited colorectal specialists in laparoscopic colorectal surgery: feasibility and evaluation of challenges

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Outreach training model for accredited colorectal specialists in laparoscopic colorectal surgery: feasibility and evaluation of challenges

et al. 2015

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“…14,15 A sebész szerepét korábbi közlések is hangsúlyozták, 16 Hartley egyenesen a sebész "bélérzéséről" ír. 19 Martel 2012-ben megjelent metaanalízise szerint eddig összesen 23 randomizált vizsgálat történt a nyitott és LAP műtétek összehasonlítására. Ha akár a műtéti időket, akár a konverziók arányát tekintjük, látható ugyan összefüggés a sebészi tapasztalat (operált esetszám) és az eredmények között, azonban egyértelmű, hogy a sebész személye inkább meghatározó, mint az esetszám.…”

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Laparoscopos colorectalis resectiók – 393 eset tapasztalatai

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et al. 2013

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Laparoscopic (LAP) colorectal surgery has become increasingly popular worldwide. Large comparative studies demonstrate the benefit of the method, but data about routine application are relatively moderate. This study presents the results of laparoscopic colorectal linterventions in a non-selected patient population, who were admitted to the 1st Department of Surgery, Semmelweis University between January 2004 and December 2011. 393 patients underwent LAP surgery. In 333 cases the malignant tumor indicated surgery. T3 tumor rate was 62.7%. Synchronous liver metastases were detected in 17 cases, three of them were single and operable, but 14 cases were multiplex and inoperable. Bowel was successfully resected in all cases. Complication rate was 9.9 percent. In-hospital mortality was 2.0%. Length of hospital stay of non-complicated cases was 6.7 days. In 9 cases single incision intervention was performed, with an average length of hospital stay of four days. Rate of sphincter preserving rectal resections were 87.2%. 59 (15.0%) patients underwent conversion from LAP to open surgery. Operating time decreased by time, but both OP time and conversion rate were tipically determinded by the surgeon's skill. LAP surgery was found to be useful for all kind colorectal diseases requiring elective resection. Application of LAP method requires organized training programs.

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“…In recent years, teaching laparoscopic colorectal procedures to colorectal consultants only proficient in open surgery has been undertaken to popularise the minimally invasive method and make it available for a broader range of patients [ 1 , 2 ]. The short-term benefits of laparoscopy on recovery, pain and length of hospital stay whilst not affecting oncological outcomes have made the method equally attractive for healthcare providers and patients [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Supervised training of laparoscopic colorectal cancer resections does not adversely affect short- and long-term outcomes: a Propensity-score-matched cohort study

2022

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Background Supervised training of laparoscopic colorectal cancer surgery to fellows and consultants (trainees) may raise doubts regarding safety and oncological adequacy. This study investigated these concerns by comparing the short- and long-term outcomes of matched supervised training cases to cases performed by the trainer himself. Methods A prospective database was analysed retrospectively. All elective laparoscopic colorectal cancer resections in curative intent of adult patients (≥ 18 years) which were performed (non-training cases) or supervised to trainees (training cases) by a single laparoscopic expert surgeon (trainer) were identified. All trainees were specialist surgeons in training for laparoscopic colorectal surgery. Supervised training was standardised. Training cases were 1:1 propensity-score matched to non-training cases using age, American Society of Anesthesiologists (ASA) grade, tumour site (rectum, left and right colon) and American Joint Committee on Cancer (AJCC) tumour stage. The resulting groups were analysed for both short- (operative, oncological, complications) and long-term (time to recurrence, overall and disease-free survival) outcomes. Results From 10/2006 to 2/2016, a total of 675 resections met the inclusion criteria, of which 95 were training cases. These resections were matched to 95 non-training cases. None of the matched covariates exhibited an imbalance greater than 0.25 (│d│>0.25). There were no significant differences in short- (length of procedure, conversion rate, blood loss, postoperative complications, R0 resections, lymph node harvest) and long-term outcomes. When comparing training cases to non-training cases, 5-year overall and disease-free survival rates were 71.6% (62.4–82.2) versus 81.9% (74.2–90.4) and 70.0% (60.8–80.6) versus 73.6% (64.9–83.3), respectively (not significant). The corresponding hazard ratios (95% confidence intervals, p) were 0.57 (0.32–1.02, p = 0.057) and 0.87 (0.51–1.48, p = 0.61), respectively (univariate Cox proportional hazard model). Conclusions Standardised supervised training of laparoscopic colorectal cancer procedures to specialist surgeons may not adversely impact short- and long-term outcomes. This result may also apply to newer surgical techniques as long as standardised teaching methods are followed.

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Impact of the English National Training Programme for laparoscopic colorectal surgery on training opportunities for senior colorectal trainees

Cited by 4 publications

References 13 publications

Outreach training model for accredited colorectal specialists in laparoscopic colorectal surgery: feasibility and evaluation of challenges

Outreach training model for accredited colorectal specialists in laparoscopic colorectal surgery: feasibility and evaluation of challenges

Laparoscopos colorectalis resectiók – 393 eset tapasztalatai

Supervised training of laparoscopic colorectal cancer resections does not adversely affect short- and long-term outcomes: a Propensity-score-matched cohort study

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