A novel difficulty scoring system for laparoscopic colorectal cancer surgery for appropriate case selection according to master
Mastering laparoscopic colorectal cancer surgery involves a learning curve. Inexperienced surgeons requireappropriate case selection. Nonetheless, there are few indicators for predicting the difficulty of laparoscopic colorectal cancer surgery. We established a difficulty scoring system to facilitat...
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| Published in | Journal of Iwate Medical Assiociation Vol. 75; no. 3; pp. 81 - 94 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Iwate Medical Association
01.08.2023
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-3284 2434-0855 |
| DOI | 10.24750/iwateishi.75.3_81 |
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| Abstract | Mastering laparoscopic colorectal cancer surgery involves a learning curve. Inexperienced surgeons requireappropriate case selection. Nonetheless, there are few indicators for predicting the difficulty of laparoscopic colorectal cancer surgery. We established a difficulty scoring system to facilitate appropriate case selection during the learning curve for laparoscopic colorectal cancer surgery until mastery is achieved.We reviewed 1,390 laparoscopic colorectal cancer surgery cases performed at our hospital. Surgical duration was used as an index of surgical difficulty. Factors related to surgical difficulty were identified using a multivariate analysis and were scored using a linear regression analysis.Overall, 889 patients were included in the analysis. Sex, body mass index 〉 25 kg/m2, and tumor location were factors that best defined surgical difficulty. The difficulty was determined by the sum of prolonged surgical duration predicted by these three factors. Surgical duration and hospital stay were longer, blood loss was greater, and complications were more common in the high difficulty group than in the low and medium difficulty groups. The developed scoring systemshowed high reliability in ten-fold cross-validation.The scoring model we developed can predict surgical difficulty for typical laparoscopic colorectal cancer surgery and may be useful in selecting appropriate surgical cases for inexperienced surgeons. |
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| AbstractList | Mastering laparoscopic colorectal cancer surgery involves a learning curve. Inexperienced surgeons requireappropriate case selection. Nonetheless, there are few indicators for predicting the difficulty of laparoscopic colorectal cancer surgery. We established a difficulty scoring system to facilitate appropriate case selection during the learning curve for laparoscopic colorectal cancer surgery until mastery is achieved.We reviewed 1,390 laparoscopic colorectal cancer surgery cases performed at our hospital. Surgical duration was used as an index of surgical difficulty. Factors related to surgical difficulty were identified using a multivariate analysis and were scored using a linear regression analysis.Overall, 889 patients were included in the analysis. Sex, body mass index 〉 25 kg/m2, and tumor location were factors that best defined surgical difficulty. The difficulty was determined by the sum of prolonged surgical duration predicted by these three factors. Surgical duration and hospital stay were longer, blood loss was greater, and complications were more common in the high difficulty group than in the low and medium difficulty groups. The developed scoring systemshowed high reliability in ten-fold cross-validation.The scoring model we developed can predict surgical difficulty for typical laparoscopic colorectal cancer surgery and may be useful in selecting appropriate surgical cases for inexperienced surgeons. |
| Author | Yaegashi, Mizunori Hatanaka, Tomoki Sasaki, Akira Sasaki, Tomoko Takashimizu, Kiyoharu Nakamura, Yuya Ariyoshi, Yu Takahash, Fumiaki Otsuka, Koki |
| Author_xml | – sequence: 1 fullname: Takashimizu, Kiyoharu organization: Department of Surgery, School of Medicine, Iwate Medical University, Yahaba, Japan – sequence: 1 fullname: Otsuka, Koki organization: Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, Toyoake, Japan – sequence: 1 fullname: Yaegashi, Mizunori organization: Department of Surgery, School of Medicine, Iwate Medical University, Yahaba, Japan – sequence: 1 fullname: Sasaki, Tomoko organization: Department of Surgery, School of Medicine, Iwate Medical University, Yahaba, Japan – sequence: 1 fullname: Sasaki, Akira organization: Department of Surgery, School of Medicine, Iwate Medical University, Yahaba, Japan – sequence: 1 fullname: Nakamura, Yuya organization: Department of Surgery, School of Medicine, Iwate Medical University, Yahaba, Japan – sequence: 1 fullname: Ariyoshi, Yu organization: Department of Surgery, School of Medicine, Iwate Medical University, Yahaba, Japan – sequence: 1 fullname: Hatanaka, Tomoki organization: Department of Surgery, School of Medicine, Iwate Medical University, Yahaba, Japan – sequence: 1 fullname: Takahash, Fumiaki organization: Center for Liberal Arts and Sciences, Iwate Medical University, Yahaba, Japan |
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| Copyright | 2023 Iwate Medical Association |
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| DOI | 10.24750/iwateishi.75.3_81 |
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| References | Cong ZJ, Fu CG, Wang HT, et al.: Influencing factors of symptomatic anastomotic leakage after anterior resection of the rectum for cancer. World J Surg 33, 1292-1297, 2009. Archampong D, Borowski D, Wille-Jørgensen P, et al.: Workload and surgeon’s specialty for outcome after colorectal cancer surgery .Cochrane Database Syst Rev 3, CD005391, 2012. Milone M, Degiuli M, Allaix ME, et al.: Mid-transverse colon cancer and extended versus transverse colectomy: Results of the Italian Society of Surgical Oncology Colorectal Cancer Network (SICO CCN) multicenter collaborative study. Eur J Surg Oncol 46, 1683-1688, 2020. Iversen LH, Harling H, Laurberg S, et al.: Influence of caseload and surgical speciality on outcome following surgery for colorectal cancer: a review of evidence. Part 1: Short-term outcome. Colorectal Dis 9, 28-37, 2007. Schlachta CM, Mamazza J, Seshadri PA, et al.: Predicting conversion to open surgery in laparoscopic colorectal resections. A simple clinical model. Surg Endosc 14, 1114-1117, 2000. Akiyoshi T, Kuroyanagi H, Oya M, et al.: Factors affecting difficulty of laparoscopic surgery for left-sided colon cancer. Surg Endosc 24, 2749-2754, 2010. Ishiguro M, Higashi T and Watanabe T: Changes in colorectal cancer care in Japan before and after guideline publication: a nationwide survey about D3 lymph node dissection and adjuvant chemotherapy. J Am Coll Surg 218, 969-977, 2014. Lange MM, Martz JE, Ramdeen B, et al.: Long-term results of rectal cancer surgery with a systematical operative approach. Ann Surg Oncol 20, 1806-1815, 2013. Nelson H, Sargent DJ, Wieand HS, et al.: A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350, 2050-2059, 2004. Schlachta CM, Mamazza J, Seshadri PA, et al.: Defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum 44, 217-222, 2001. Matsumoto M, Abe K, Futagawa Y, et al.: New scoring system for prediction of surgical difficulty during laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage. Ann Gastroenterol Surg 6, 296-306, 2022. Jestin P, Påhlman L and Gunnarsson U: Risk factors for anastomotic leakage after rectal cancer surgery: a case-control study. Colorectal Dis 10, 715-721, 2008. Jamali FR, Soweid AM, Dimassi H, et al.: Evaluating the degree of difficulty of laparoscopic colorectal surgery. Arch Surg 143, 762-767, 2008. Mistrangelo M, Allaix ME, Cassoni P, et al.: Laparoscopic versus open resection for transverse colon cancer. Surg Endosc 29, 2196-2202, 2015. Otsuka K, Kimura T, Matsuo T, et al.: Laparoscopic low anterior resection with two planned stapler fires. JSLS 23, e2018, 2019. Fung A, Trabulsi N, Morris M, et al.: Laparoscopic colorectal cancer resections in the obese: a systematic review. Surg Endosc 31, 2072-2088, 2017. Veenhof AA, Engel AF, van der Peet DL, et al.: Technical difficulty grade score for the laparoscopic approach of rectal cancer: a single institution pilot study. Int J Colorectal Dis 23, 469-475, 2008. Lacy AM, García-Valdecasas JC, Delgado S, et al.: Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359, 2224-2229, 2002. West NP, Kobayashi H, Takahashi K, et al.: Understanding optimal colonic cancer surgery: comparison of Japanese D3 resection and European complete mesocolic excision with central vascular ligation. J Clin Oncol 30, 1763-1769, 2012. Li JC, Hon SS, Ng SS, et al.: The learning curve for laparoscopic colectomy: experience of a surgical fellow in an university colorectal unit. Surg Endosc 23, 1603-1608, 2009. Dindo D, Demartines N and Clavien PA: Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240, 205–213, 2004. Toyoshima A, Nishizawa T, Sunami E, et al.: Narrow pelvic inlet plane area and obesity as risk factors for anastomotic leakage after intersphincteric resection. World J Gastrointest Surg 12, 425-434, 2020. Kobayashi H and West NP : CME versus D3 dissection for colon cancer. Clin Colon Rectal Surg 33, 344-348, 2020. Vogel JD, Eskicioglu C, Weiser MR, et al.: The American Society of Colon and Rectal Surgeons clinical practice guidelines for the treatment of colon cancer. Dis Colon Rectum 60, 999-1017, 2017. Mori T, Kimura T and Kitajima M: Skill accreditation system for laparoscopic gastro-enterologic surgeons in Japan. Minim Invasive Ther Allied Technol. 19, 18-23, 2010. Guillou PJ, Quirke P, Thorpe H, et al.: Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365, 1718-1726, 2005. Jayne DG, Guillou PJ, Thorpe H, et al.: Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25, 3061-3068, 2007. Gupta N, Ranjan G, Arora MP, et al.: Validation of a scoring system to predict difficult laparoscopic cholecystectomy. Int J Surg 11, 1002-1006, 2013. Arnold M, Abnet CC, Neale RE, et al.: Global burden of 5 major types of gastrointestinal cancer. Gastroenterology 159, 335-349, 2020. Akagi T, Endo H, Inomata M, et al.: Clinical impact of Endoscopic Surgical Skill Qualification System (ESSQS) by Japan Society for Endoscopic Surgery (JSES) for laparoscopic distal gastrectomy and low anterior resection based on the National Clinical Database (NCD) registry. Ann Gastroenterol Surg 4, 721-734, 2020. Kitano S, Inomata M, Mizusawa J, et al.: Survival outcomes following laparoscopic versus open D3 dissection for stage II or III colon cancer (JCOG0404): a phase 3, randomised controlled trial. Lancet Gastroenterol Hepatol 2, 261-268, 2017. Tekkis PP, Senagore AJ and Delaney CP: Conversion rates in laparoscopic colorectal surgery: a predictive model with, 1253 patients. Surg Endosc 19, 47-54, 2005. Hasegawa Y, Wakabayashi G, Nitta H, et al.: A novel model for prediction of pure laparoscopic liver resection surgical difficulty. Surg Endosc 31, 5356-5363, 2017. Palmer BF and Clegg DJ: The sexual dimorphism of obesity. Mol Cell Endocrinol 402, 113-119, 2015. Yang T, Wei M, He Y, et al.: Impact of visceral obesity on outcomes of laparoscopic colorectal surgery: a meta-analysis. ANZ J Surg 85, 507-513, 2015. You YN, Hardiman KM, Bafford A, et al.: The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of rectal cancer. Dis Colon Rectum 63, 1191-1222, 2020. Japanese Society for Cancer of the Colon and Rectum : Japanese classification of colorectal, appendiceal, and anal carcinoma: the 3d. English ed. [secondary publication]. J Anus Rectum Colon. 3, 175-195, 2019. He Y, Wang J, Bian H, et al.: BMI as a predictor for perioperative outcome of laparoscopic colorectal surgery: a pooled analysis of comparative studies. Dis Colon Rectum 60, 433-445, 2017. Iversen LH, Harling H and Laurberg S: Influence of caseload and surgical speciality on outcome following surgery for colorectal cancer: a review of evidence. Part 2: Long-term outcome. Colorectal Dis 9, 38–46, 2007. Nassar AHM, Hodson J, Ng HJ, et al.: Pre-dicting the difficult laparoscopic cholecystectomy: development and validation of a pre-operative risk score using an objective operative difficulty grading system. Surg Endosc 34, 4549-4561, 2020. Hashiguchi Y, Muro K, Saito Y, et al.: Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol 25, 1-42, 2020. Tekkis PP, Senagore AJ, Delaney CP, et al.: Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left-sided resections. Ann Surg 242, 83-91, 2005. Rullier E, Laurent C, Garrelon JL, et al.: Risk factors for anastomotic leakage after resection of rectal cancer. Br J Surg 85, 355–358, 1998. Akiyoshi T, Kuroyanagi H, Ueno M, et al.: Learning curve for standardized laparoscopic surgery for colorectal cancer under supervision: a single-center experience. Surg Endosc 25, 1409-1414, 2011. Buunen M, Veldkamp R, Hop WC, et al.: Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 10, 44-52, 2009. van der Pas MH, Haglind E, Cuesta MA, et al.: Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 14, 210-218, 2013. Ye C, Wang X, Sun Y, et al.: A nomogram pre-dicting the difficulty of laparoscopic surgery for rectal cancer. Surg Today 51, 1835-1842, 2021. Krizzuk D, Yellinek S, Parlade A, et al.: A simple difficulty scoring system for laparoscopic total mesorectal excision. Tech Coloproctol 24, 1137–1143, 2020. Green BL, Marshall HC, Collinson F, et al.: Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg 100, 75-82, 2013. Thorpe H, Jayne DG, Guillou PJ, et al.: Patient factors influencing conversion from laparoscopically assisted to open surgery for colorectal cancer. Br J Surg 95, 199-205, 2008. Otsuka K, Kimura T, Hakozaki M, et al.: Comparative benefits of laparoscopic surgery for colorectal cancer in octogenarians: a case-matched comparison of short- and long-term outcomes with middle-aged patients. Surg Today 47, 587-594, 2017. Kuhry E, Bonjer HJ, Haglind E, et al.: Impact of hospital case volume on short-term outcome after laparoscopic operation for colonic cancer. Surg Endosc 19, 687-692, 2005. Ban D, Tanabe M, Ito H, et al.: A novel difficulty scoring system for laparoscopic liver resection. J Hepatobiliary Pancreat Sci 21, 745-753, 2014. Deijen CL, Vasmel JE, de Lange-de Klerk ESM, et al.: Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer. Surg Endosc 31, 2607-2615, 2017. |
| References_xml | – reference: Guillou PJ, Quirke P, Thorpe H, et al.: Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365, 1718-1726, 2005. – reference: Hashiguchi Y, Muro K, Saito Y, et al.: Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol 25, 1-42, 2020. – reference: Kobayashi H and West NP : CME versus D3 dissection for colon cancer. Clin Colon Rectal Surg 33, 344-348, 2020. – reference: West NP, Kobayashi H, Takahashi K, et al.: Understanding optimal colonic cancer surgery: comparison of Japanese D3 resection and European complete mesocolic excision with central vascular ligation. J Clin Oncol 30, 1763-1769, 2012. – reference: Krizzuk D, Yellinek S, Parlade A, et al.: A simple difficulty scoring system for laparoscopic total mesorectal excision. Tech Coloproctol 24, 1137–1143, 2020. – reference: Otsuka K, Kimura T, Hakozaki M, et al.: Comparative benefits of laparoscopic surgery for colorectal cancer in octogenarians: a case-matched comparison of short- and long-term outcomes with middle-aged patients. Surg Today 47, 587-594, 2017. – reference: Ishiguro M, Higashi T and Watanabe T: Changes in colorectal cancer care in Japan before and after guideline publication: a nationwide survey about D3 lymph node dissection and adjuvant chemotherapy. J Am Coll Surg 218, 969-977, 2014. – reference: Jamali FR, Soweid AM, Dimassi H, et al.: Evaluating the degree of difficulty of laparoscopic colorectal surgery. Arch Surg 143, 762-767, 2008. – reference: Ye C, Wang X, Sun Y, et al.: A nomogram pre-dicting the difficulty of laparoscopic surgery for rectal cancer. Surg Today 51, 1835-1842, 2021. – reference: Yang T, Wei M, He Y, et al.: Impact of visceral obesity on outcomes of laparoscopic colorectal surgery: a meta-analysis. ANZ J Surg 85, 507-513, 2015. – reference: Jestin P, Påhlman L and Gunnarsson U: Risk factors for anastomotic leakage after rectal cancer surgery: a case-control study. Colorectal Dis 10, 715-721, 2008. – reference: Veenhof AA, Engel AF, van der Peet DL, et al.: Technical difficulty grade score for the laparoscopic approach of rectal cancer: a single institution pilot study. Int J Colorectal Dis 23, 469-475, 2008. – reference: Akiyoshi T, Kuroyanagi H, Oya M, et al.: Factors affecting difficulty of laparoscopic surgery for left-sided colon cancer. Surg Endosc 24, 2749-2754, 2010. – reference: Kitano S, Inomata M, Mizusawa J, et al.: Survival outcomes following laparoscopic versus open D3 dissection for stage II or III colon cancer (JCOG0404): a phase 3, randomised controlled trial. Lancet Gastroenterol Hepatol 2, 261-268, 2017. – reference: Lacy AM, García-Valdecasas JC, Delgado S, et al.: Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359, 2224-2229, 2002. – reference: Matsumoto M, Abe K, Futagawa Y, et al.: New scoring system for prediction of surgical difficulty during laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage. Ann Gastroenterol Surg 6, 296-306, 2022. – reference: Mistrangelo M, Allaix ME, Cassoni P, et al.: Laparoscopic versus open resection for transverse colon cancer. Surg Endosc 29, 2196-2202, 2015. – reference: Nassar AHM, Hodson J, Ng HJ, et al.: Pre-dicting the difficult laparoscopic cholecystectomy: development and validation of a pre-operative risk score using an objective operative difficulty grading system. Surg Endosc 34, 4549-4561, 2020. – reference: Green BL, Marshall HC, Collinson F, et al.: Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg 100, 75-82, 2013. – reference: Thorpe H, Jayne DG, Guillou PJ, et al.: Patient factors influencing conversion from laparoscopically assisted to open surgery for colorectal cancer. Br J Surg 95, 199-205, 2008. – reference: Buunen M, Veldkamp R, Hop WC, et al.: Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 10, 44-52, 2009. – reference: Iversen LH, Harling H, Laurberg S, et al.: Influence of caseload and surgical speciality on outcome following surgery for colorectal cancer: a review of evidence. Part 1: Short-term outcome. Colorectal Dis 9, 28-37, 2007. – reference: Gupta N, Ranjan G, Arora MP, et al.: Validation of a scoring system to predict difficult laparoscopic cholecystectomy. Int J Surg 11, 1002-1006, 2013. – reference: Jayne DG, Guillou PJ, Thorpe H, et al.: Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25, 3061-3068, 2007. – reference: Toyoshima A, Nishizawa T, Sunami E, et al.: Narrow pelvic inlet plane area and obesity as risk factors for anastomotic leakage after intersphincteric resection. World J Gastrointest Surg 12, 425-434, 2020. – reference: Ban D, Tanabe M, Ito H, et al.: A novel difficulty scoring system for laparoscopic liver resection. J Hepatobiliary Pancreat Sci 21, 745-753, 2014. – reference: Vogel JD, Eskicioglu C, Weiser MR, et al.: The American Society of Colon and Rectal Surgeons clinical practice guidelines for the treatment of colon cancer. Dis Colon Rectum 60, 999-1017, 2017. – reference: Tekkis PP, Senagore AJ and Delaney CP: Conversion rates in laparoscopic colorectal surgery: a predictive model with, 1253 patients. Surg Endosc 19, 47-54, 2005. – reference: Palmer BF and Clegg DJ: The sexual dimorphism of obesity. Mol Cell Endocrinol 402, 113-119, 2015. – reference: Rullier E, Laurent C, Garrelon JL, et al.: Risk factors for anastomotic leakage after resection of rectal cancer. Br J Surg 85, 355–358, 1998. – reference: Schlachta CM, Mamazza J, Seshadri PA, et al.: Predicting conversion to open surgery in laparoscopic colorectal resections. A simple clinical model. Surg Endosc 14, 1114-1117, 2000. – reference: Mori T, Kimura T and Kitajima M: Skill accreditation system for laparoscopic gastro-enterologic surgeons in Japan. Minim Invasive Ther Allied Technol. 19, 18-23, 2010. – reference: Nelson H, Sargent DJ, Wieand HS, et al.: A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350, 2050-2059, 2004. – reference: He Y, Wang J, Bian H, et al.: BMI as a predictor for perioperative outcome of laparoscopic colorectal surgery: a pooled analysis of comparative studies. Dis Colon Rectum 60, 433-445, 2017. – reference: Fung A, Trabulsi N, Morris M, et al.: Laparoscopic colorectal cancer resections in the obese: a systematic review. Surg Endosc 31, 2072-2088, 2017. – reference: Akagi T, Endo H, Inomata M, et al.: Clinical impact of Endoscopic Surgical Skill Qualification System (ESSQS) by Japan Society for Endoscopic Surgery (JSES) for laparoscopic distal gastrectomy and low anterior resection based on the National Clinical Database (NCD) registry. Ann Gastroenterol Surg 4, 721-734, 2020. – reference: Li JC, Hon SS, Ng SS, et al.: The learning curve for laparoscopic colectomy: experience of a surgical fellow in an university colorectal unit. Surg Endosc 23, 1603-1608, 2009. – reference: You YN, Hardiman KM, Bafford A, et al.: The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of rectal cancer. Dis Colon Rectum 63, 1191-1222, 2020. – reference: Lange MM, Martz JE, Ramdeen B, et al.: Long-term results of rectal cancer surgery with a systematical operative approach. Ann Surg Oncol 20, 1806-1815, 2013. – reference: Deijen CL, Vasmel JE, de Lange-de Klerk ESM, et al.: Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer. Surg Endosc 31, 2607-2615, 2017. – reference: Kuhry E, Bonjer HJ, Haglind E, et al.: Impact of hospital case volume on short-term outcome after laparoscopic operation for colonic cancer. Surg Endosc 19, 687-692, 2005. – reference: van der Pas MH, Haglind E, Cuesta MA, et al.: Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 14, 210-218, 2013. – reference: Akiyoshi T, Kuroyanagi H, Ueno M, et al.: Learning curve for standardized laparoscopic surgery for colorectal cancer under supervision: a single-center experience. Surg Endosc 25, 1409-1414, 2011. – reference: Cong ZJ, Fu CG, Wang HT, et al.: Influencing factors of symptomatic anastomotic leakage after anterior resection of the rectum for cancer. World J Surg 33, 1292-1297, 2009. – reference: Tekkis PP, Senagore AJ, Delaney CP, et al.: Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left-sided resections. Ann Surg 242, 83-91, 2005. – reference: Arnold M, Abnet CC, Neale RE, et al.: Global burden of 5 major types of gastrointestinal cancer. Gastroenterology 159, 335-349, 2020. – reference: Dindo D, Demartines N and Clavien PA: Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240, 205–213, 2004. – reference: Schlachta CM, Mamazza J, Seshadri PA, et al.: Defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum 44, 217-222, 2001. – reference: Japanese Society for Cancer of the Colon and Rectum : Japanese classification of colorectal, appendiceal, and anal carcinoma: the 3d. English ed. [secondary publication]. J Anus Rectum Colon. 3, 175-195, 2019. – reference: Otsuka K, Kimura T, Matsuo T, et al.: Laparoscopic low anterior resection with two planned stapler fires. JSLS 23, e2018, 2019. – reference: Hasegawa Y, Wakabayashi G, Nitta H, et al.: A novel model for prediction of pure laparoscopic liver resection surgical difficulty. Surg Endosc 31, 5356-5363, 2017. – reference: Archampong D, Borowski D, Wille-Jørgensen P, et al.: Workload and surgeon’s specialty for outcome after colorectal cancer surgery .Cochrane Database Syst Rev 3, CD005391, 2012. – reference: Iversen LH, Harling H and Laurberg S: Influence of caseload and surgical speciality on outcome following surgery for colorectal cancer: a review of evidence. Part 2: Long-term outcome. Colorectal Dis 9, 38–46, 2007. – reference: Milone M, Degiuli M, Allaix ME, et al.: Mid-transverse colon cancer and extended versus transverse colectomy: Results of the Italian Society of Surgical Oncology Colorectal Cancer Network (SICO CCN) multicenter collaborative study. Eur J Surg Oncol 46, 1683-1688, 2020. |
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| Title | A novel difficulty scoring system for laparoscopic colorectal cancer surgery for appropriate case selection according to master |
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| ispartofPNX | Journal of Iwate Medical Assiociation, 2023, Vol.75(3), pp.81-94 |
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