Miljan Ceranic, Gendia Ahmed, Rehman Masood U R, Blagoje Djukanovic, Mladen Janic, Igor Krdzic, Nebojsa Stojakovic, Aleksandar Gluhovic, Zlatibor Loncar, Ahmed Jamil, Amjad Parvaiz
First Surgical Clinic, University Clinical Center of Serbia, Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Surg Endosc. 2023 Apr;37(4):2943-2948. doi: 10.1007/s00464-022-09795-6. Epub 2022 Dec 12.
The Serbian National Training Programme for minimally invasive colorectal surgery (LapSerb) was introduced to implement laparoscopic colorectal surgery across Serbia. The programme aimed to accelerate training of established colorectal surgeons through a competency-based programme. This involved knowledge assessment, workshops, live operating, and competency-based assessment of unedited videos. The aim of this study is to report the outcomes of laparoscopic colorectal resection performed by LapSerb certified surgeons.
LapSerb prospectively maintained multicentred database was analysed for laparoscopic colorectal resections from January 2015 to February 2021. Data collected included patient demographics, indications for surgery, perioperative data, and 30-day outcomes.
A total of 1456 laparoscopic colectomies by 24 certified surgeons were included in the final analysis. Mean age was 67 (± 12) years old and male to female ratio was 1:1.5. 83.1% of the colectomies were malignant, mainly due to adenocarcinoma. Anterior resection was the most common procedure with 699 (48%) cases, followed by right and left colectomies with 357 (24.5%) and 303 (21%) procedure respectively. 4.8% of patients required conversion to open surgery. Thirty-day readmission and reoperation rates were 2.3% and 4.7%, respectively. Overall mortality in all cases was 1.1% and R0 resections were achieved in 97.8% of malignant colectomies.
The LapSerb programme successfully and safely established laparoscopic colorectal surgery across the country with comparable and acceptable short-term clinical outcomes.
塞尔维亚国家微创结直肠手术培训项目（LapSerb）旨在在塞尔维亚全国推行腹腔镜结直肠手术。该项目旨在通过基于能力的培训计划加速对经验丰富的结直肠外科医生的培训。这包括知识评估、研讨会、现场手术以及对未经编辑的视频进行基于能力的评估。本研究的目的是报告获得LapSerb认证的外科医生进行腹腔镜结直肠切除术的结果。
对LapSerb前瞻性维护的多中心数据库进行分析，纳入2015年1月至2021年2月期间的腹腔镜结直肠切除术。收集的数据包括患者人口统计学资料、手术指征、围手术期数据和30天结局。
最终分析纳入了24名获得认证的外科医生进行的1456例腹腔镜结肠切除术。平均年龄为67（±12）岁，男女比例为1:1.5。83.1%的结肠切除术为恶性，主要原因是腺癌。前切除术是最常见的手术方式，共699例（48%），其次是右半结肠切除术和左半结肠切除术，分别为357例（24.5%）和303例（21%）。4.8%的患者需要转为开放手术。30天再入院率和再次手术率分别为2.3%和4.7%。所有病例的总体死亡率为1.1%，97.8%的恶性结肠切除术实现了R0切除。
LapSerb项目在全国成功且安全地建立了腹腔镜结直肠手术，短期临床结局具有可比性且可接受。
