Impact of a Nationwide Training Program in Minimally Invasive Distal Pancreatectomy (LAELAPS)
| Autor: | Ignace H. J. T. de Hingh, Misha D. P. Luyer, Sebastiaan Festen, Bas Groot Koerkamp, Geert Kazemier, Erwin van der Harst, Daphne Roos, Mohammed Abu Hilal, Thijs de Rooij, Gijs A. Patijn, Daan J. Lips, Ruben H J de Kleine, George P. van der Schelling, Pascal Steenvoorde, Casper H.J. van Eijck, Joost M. Klaase, I. Quintus Molenaar, Djamila Boerma, Cornelis J. H. M. van Laarhoven, Jan H. Wijsman, Dirk J. Gouma, Olivier R. Busch, Marc G. Besselink, Menno R. Vriens, Freek Daams, Ronald M. van Dam, Jony van Hilst, Bert A. Bonsing, Marcel G. W. Dijkgraaf, Joris J. Scheepers, Michael F. Gerhards |
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| Přispěvatelé: | Surgery, CCA - Evaluation of Cancer Care, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, Graduate School, Clinical Research Unit, Other departments, Groningen Institute for Organ Transplantation (GIOT), Value, Affordability and Sustainability (VALUE), RS: NUTRIM School of Nutrition and Translational Research in Metabolism, RS: NUTRIM - R2 - Gut-liver homeostasis, MUMC+: MA Heelkunde (9) |
| Rok vydání: | 2016 |
| Předmět: |
Laparoscopic surgery
Male Pancreatic disease medicine.medical_treatment pancreatic cancer INTERNATIONAL STUDY-GROUP REALITY SIMULATOR 030230 surgery Cohort Studies Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] 0302 clinical medicine Robotic Surgical Procedures SURGERY ISGPS distal pancreatectomy pancreatic surgery Netherlands robot-assisted surgery training Middle Aged META-ANALYSIS laparoscopic surgery CANCER Treatment Outcome 030220 oncology & carcinogenesis Pancreatectomy Female Training program Distal pancreatectomy Cohort study Adult medicine.medical_specialty CADAVER education DUCTAL ADENOCARCINOMA CONTROLLED-TRIAL 03 medical and health sciences Blood loss Pancreatic cancer Pancreatitis Chronic medicine Humans METAANALYSIS Aged business.industry medicine.disease Surgery Pancreatic Neoplasms DEFINITION Controlled Before-After Studies Feasibility Studies Laparoscopy business pancreatic disease |
| Zdroj: | Annals of Surgery, 264(5), 754-762. Lippincott Williams and Wilkins Annals of Surgery, 264(5), 754-762. Lippincott Williams & Wilkins Annals of surgery, 264(5), 754-762. Lippincott Williams and Wilkins Annals of Surgery, 264(5), 754-762. LIPPINCOTT WILLIAMS & WILKINS Annals of Surgery, 264, 754-762 de Rooij, T, van Hilst, J, Boerma, D, Bonsing, B A, Daams, F, van Dam, R M, Dijkgraaf, M G, van Eijck, C H, Festen, S, Gerhards, M F, Koerkamp, B G, van der Harst, E, de Hingh, I H, Kazemier, G, Klaase, J, de Kleine, R H, van Laarhoven, C J, Lips, D J, Luyer, M D, Molenaar, I Q, Patijn, G A, Roos, D, Scheepers, J J, van der Schelling, G P, Steenvoorde, P, Vriens, M R, Wijsman, J H, Gouma, D J, Busch, O R, Hilal, M A & Besselink, M G 2016, ' Impact of a Nationwide Training Program in Minimally Invasive Distal Pancreatectomy (LAELAPS) ', Annals of Surgery, vol. 264, no. 5, pp. 754-762 . https://doi.org/10.1097/SLA.0000000000001888 Annals of Surgery, 264, 5, pp. 754-762 Annals of Surgery, 264(5), 754-762 |
| ISSN: | 1528-1140 0003-4932 |
| DOI: | 10.1097/SLA.0000000000001888 |
| Popis: | Item does not contain fulltext OBJECTIVE: To study the feasibility and impact of a nationwide training program in minimally invasive distal pancreatectomy (MIDP). SUMMARY OF BACKGROUND DATA: Superior outcomes of MIDP compared with open distal pancreatectomy have been reported. In the Netherlands (2005 to 2013) only 10% of distal pancreatectomies were in a minimally invasive fashion and 85% of surgeons welcomed MIDP training. The feasibility and impact of a nationwide training program is unknown. METHODS: From 2014 to 2015, 32 pancreatic surgeons from 17 centers participated in a nationwide training program in MIDP, including detailed technique description, video training, and proctoring on-site. Outcomes of MIDP before training (2005-2013) were compared with outcomes after training (2014-2015). RESULTS: In total, 201 patients were included; 71 underwent MIDP in 9 years before training versus 130 in 22 months after training (7-fold increase, P < 0.001). The conversion rate (38% [n = 27] vs 8% [n = 11], P < 0.001) and blood loss were lower after training and more pancreatic adenocarcinomas were resected (7 [10%] vs 28 [22%], P = 0.03), with comparable R0-resection rates (4/7 [57%] vs 19/28 [68%], P = 0.67). Clavien-Dindo score >/=III complications (15 [21%] vs 19 [15%], P = 0.24) and pancreatic fistulas (20 [28%] vs 41 [32%], P = 0.62) were not significantly different. Length of hospital stay was shorter after training (9 [7-12] vs 7 [5-8] days, P < 0.001). Thirty-day mortality was 3% vs 0% (P = 0.12). CONCLUSION: A nationwide MIDP training program was feasible and followed by a steep increase in the use of MIDP, also in patients with pancreatic cancer, and decreased conversion rates. Future studies should determine whether such a training program is applicable in other settings. |
| Databáze: | OpenAIRE |
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