Objective: The aim of this study is to identify learning curves for robotic gastro-enterostomy (RGE) during RPD and the predictive value of the objective structured assessment of technical skills (OSATS) score for DGE according to the Birkmeyer et al and UPMC method.
Summary Of Background Data: In some series, robotic pancreatoduodenectomy (RPD) has been associated with increased risk of delayed gastric emptying (DGE). It is unclear whether this is attributable to learning curve. Improved surgical performance and experience has not yet been linked to a decrease in delayed gastric emptying in RPD.
Methods: Post-hoc study of the prospective multicenter (LAELAPS-3) training program including videos of RGE during RPD. Surgical performance was scored with OSATS by two blinded graders. The main outcomes are the combined OSATS scores of two blinded graders over time (learning curve). Secondary outcome is the correlation between OSATS scores and clinically relevant DGE (grade B/C).
Results: Videos from 192 RGE anastomoses were included. DGE occurred in 42/192 (21.9%) patients. Mean OSATS score was 22.4 (SD±5.1) and predicted DGE (AUC 0.668, P<0.001). The predictive OSATS elements for DGE were gentleness (AUC 0.719, P<0.001), instrument handling (AUC 0.595 P=0.043), tissue exposure (AUC 0.625, P=0.009), and summary score (AUC 0.665, P<0.001). An OSATS score >25 was associated with a 59.9% reduced relative risk of grade B/C DGE (11.3% (8/71) vs 28.1% (34/121); OR 0.325, P=0.006). CUSUM analysis of RGE-OSATS identified a turning point at 34 procedures (27.5% (36/140) before vs 11.5% (6/52) after; OR 0.156, P=0.035. On multivariable analysis for grade B/C DGE, OSATS ≤25 remained an independent risk factor (OR 2.907, P=0.028).
Conclusions: Better surgical performance during gastro-enteric anastomosis in RPD, as assessed by OSATS, is associated with a reduced rate of grade B/C DGE. OSATS could serve as a tool for competency-based training programs and quality-controlled implementation of RPD.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/SLA.0000000000006692 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association Between Mortality and Detection of Respiratory Viruses in Children During the Peri-Liver Transplant Period.
Pediatr Infect Dis J
March 2025
Department of Pediatrics and Intensive Care Medicine.
Background: To evaluate the disease burden, risk of complications and mortality in children with viral detection during the peri-liver transplant period.
Methods: A retrospective cohort study was conducted between January 2020 and December 2023 at a tertiary university hospital. Children who underwent multiplex polymerase chain reaction testing from 7 days before to 14 days after liver transplantation were included.
Non-targeted metabolomic study in plasma in rats with post-traumatic osteoarthritis model.
PLoS One
March 2025
Department of Orthopaedics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China.
Purpose: This study aimed to examine the differential expression profiles of plasma metabolites in rat models of post-traumatic osteoarthritis (PTOA) and elucidate the roles of metabolites and their pathways in the progression of PTOA using bioinformatics analysis.
Method: Plasma samples were collected from 24 SD female rats to model PTOA, and metabolomic assays were conducted. The samples were divided into three groups: the surgically induced mild PTOA group (Group A: 3 weeks postoperative using the modified Hulth model; age 2 months), the surgically induced severe PTOA group (Group B: 5 weeks postoperative using the modified Hulth model; age 2 months), and the normal control group (Group C: healthy rats aged 2 months).
Sex-related differences in systemic inflammatory response and outcomes after cardiac surgery and cardiopulmonary bypass.
Interdiscip Cardiovasc Thorac Surg
March 2025
Division of Cardiac Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Objectives: Differences in inflammatory responses between men and women may contribute to sex disparities in cardiac surgery outcomes. We investigated how sex differences influence systemic inflammatory response syndrome (SIRS) and adverse outcomes after cardiac surgery.
Methods: A single-center retrospective cohort study of patients undergoing cardiac surgery from 2018 to 2020 was performed.
Staged hybrid approach for acute type A aortic dissection: zone 2 arch replacement and completion thoracic endovascular aortic repair upon indication.
Eur J Cardiothorac Surg
March 2025
Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, Netherlands.
Objectives: This study evaluates a staged selective hybrid approach for acute type A aortic dissection. The approach involves a zone 2 aortic arch replacement with debranching of the brachiocephalic trunk and left common carotid artery to create a landing zone for thoracic endovascular aortic repair. This repair is performed either preemptively in the subacute phase to promote remodelling or electively in the chronic phase to manage aneurysm formation.
View Article and Find Full Text PDFSurgical management for caseous calcification of mitral annulus associated with coronary artery disease.
Interdiscip Cardiovasc Thorac Surg
March 2025
Department of Cardiovascular Surgery, Anjo Kosei Hospital, Anjo, Aichi, 446-8602, Japan.
Mitral annular calcification (MAC) is a common finding, especially among the elderly or patients undergoing hemodialysis. Caseous calcification of the mitral annulus (CCMA) is a rare MAC variant with liquefied material at the calcified annulus. Surgical management of CCMA often involves wide excision and debridement, increasing the risk of perioperative stroke.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!