ArticleSurgical endoscopy2025
Effect of endoscopic surgical skill qualification system for laparoscopic rectal surgery: Japanese multicenter analysis.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Interaction Between Operator and Assistant Certification Is Associated With Local Recurrence After Laparoscopic Rectal Cancer Surgery: An Ancillary Analysis of the EnSSURE Study.Annals of gastroenterological surgery · 2026Article
- Utility of establishing a unified regional database for enhancing academic output and specialist certification in Japan.Surgery today · 2026Article
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic rectal surgery is often technically difficult. The Endoscopic Surgical Skill Qualification System (ESSQS) was established in Japan as an objective measure of skill for laparoscopic surgeons. However, the advantages of the ESSQS qualification for laparoscopic rectal surgery have been limited. The aim of this multicenter study was to assess the effects of the ESSQS on short- and long-term outcomes for laparoscopic rectal cancer surgery.
methodsWe retrospectively reviewed 933 rectal cancer patients who underwent laparoscopic surgery between 2016 and 2023. Patients were divided into two groups: those for whom surgery was performed by an ESSQS-qualified surgeon (Expert group, n = 568); and those for whom surgery was performed by an ESSQS-unqualified surgeon (Non-expert group, n = 365). After propensity score matching, 299 patients from each group were matched. Short- and long-term outcomes were compared between groups.
resultsBefore matching, the Expert group showed greater frequencies of poor performance status (PS) (PS ≥ 3, 10.6% vs 4.1%, p < 0.001), lower rectum cancer (32.0% vs 18.4%, p < 0.001), preoperative treatment (17.3% vs 8.2%, p < 0.001), and pelvic lymph node dissection (30.8% vs 21.4%, p = 0.001). After matching, the Expert group showed lower frequencies of open conversion (0.3% vs 2.3%, p = 0.034) and postoperative complications (18.1% vs 26.1%, p = 0.037). Relapse-free survival (p = 0.811) and overall survival (p = 0.374) were similar between groups.
conclusionSuperior results such as lower conversion rates and postoperative complication rates were obtained for laparoscopic rectal surgery performed by ESSQS-qualified surgeons.
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