Validation study of a skill assessment tool for education and outcome prediction of laparoscopic distal gastrectomy
Validation study of a skill assessment tool for education and outcome prediction of laparoscopic distal gastrectomy
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DOI：
10.1007/s00464-022-09305-8
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发表时间：
2022-05-16
影响因子：
3.1
通讯作者：
Hirano, Satoshi
中科院分区：
文献类型：
--
作者：
Kurashima, Yo;Kitagami, Hidehiko;Hirano, Satoshi
背景日本腹腔镜远端胃切除术手术评分量表（JORS-LDG）是通过认知任务分析和德尔菲法开发的，用于测量腹腔镜远端胃切除术的术中表现。本研究旨在探讨该评分量表作为腹腔镜远端胃切除术中的教育工具和手术结果预测因素的价值。方法由一助、手术室自我评估和视频评分员对腹腔镜远端胃切除术的手术效果进行评估。我们评估了评估者间的可靠性、内部一致性以及JORS-LDG评分与评估方法、患者特征和手术结局之间的相关性。结果54例腹腔镜远端胃切除术的40名外科医生在16个机构进行了评估，在手术室和视频记录使用建议的评级量表。视频评分员间信度> 0.8。参与的外科医生根据他们的总分分为低，中，高组。根据腹腔镜远端胃切除术的技能水平，各组之间进行的腹腔镜手术和腹腔镜胃切除术的数量存在显著差异。低、中和高组在中位手术时间（分别为311、266和229 min，P < 0.001）、术中并发症发生率（分别为27.8、11.8和0%，P = 0.01）和术后并发症发生率（分别为22.2、0和0%，P = 0.002）方面也存在差异。结论JORS-LDG是腹腔镜远端胃切除术训练的一种可靠有效的方法，可用于预测手术效果。
Background The Japanese operative-rating scale for laparoscopic distal gastrectomy (JORS-LDG) was developed through cognitive task analysis together with the Delphi method to measure intraoperative performance during laparoscopic distal gastrectomy. This study aimed to investigate the value of this rating scale as an educational tool and a surgical outcome predictor in laparoscopic distal gastrectomy. Methods The surgical performance of laparoscopic distal gastrectomy was assessed by the first assistant, through self-evaluation in the operating room and by video raters blind to the case. We evaluated inter-rater reliability, internal consistency, and correlations between the JORS-LDG scores and the evaluation methods, patient characteristics, and surgical outcomes. Results Fifty-four laparoscopic distal gastrectomy procedures performed by 40 surgeons at 16 institutions were evaluated in the operating room and with video recordings using the proposed rating scale. The video inter-rater reliability was > 0.8. Participating surgeons were divided into the low, intermediate, and high groups based on their total scores. The number of laparoscopic surgeries and laparoscopic gastrectomy procedures performed differed significantly among the groups according to laparoscopic distal gastrectomy skill levels. The low, intermediate, and high groups also differed in terms of median operating times (311, 266, and 229 min, respectively, P < 0.001), intraoperative complication rates (27.8, 11.8, and 0%, respectively, P = 0.01), and postoperative complication rates (22.2, 0, and 0%, respectively, P = 0.002). Conclusions The JORS-LDG is a reliable and valid measure for laparoscopic distal gastrectomy training and could be useful in predicting surgical outcomes.