{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T04:28:56Z","timestamp":1793075336769,"version":"4.5.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T00:00:00Z","timestamp":1702512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A technical qualification system was developed in 2004 by the Japan Society for Endoscopic Surgery. An analysis of the EnSSURE study on 3188 stage II\u2013III rectal cancer patients, which was performed by including the participation of qualified surgeons as assistants and advisers without restricting their participation as operators, revealed that the participation of technically qualified surgeons in surgery improved the technical and oncological safety of laparoscopic rectal resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This secondary retrospective analysis of the EnSSURE study examined the advantage of qualified surgeons participating in laparoscopic low anterior resection (LAR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The outcomes of low anterior resection were compared between groups with and without the participation of surgeons qualified by the Endoscopic Surgical Skill Qualification System (<jats:italic>Q<\/jats:italic> and non\u2010<jats:italic>Q<\/jats:italic> groups, respectively). We used propensity score matching to generate paired cohorts at a one\u2010to\u2010one ratio. The postoperative complication rate, short\u2010term results (hemorrhage volume, operative time, number of dissected lymph nodes, open conversion rate, intraoperative complication rate, and R0 resection rate), and long\u2010term results (disease\u2010free survival rate, local recurrence rate, and overall survival rate) were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The frequencies of postoperative complications, anastomotic bleeding, and intraperitoneal abscess were significantly lower, the operative time was significantly shorter, the postoperative hospital stay was significantly shorter, and the number of dissected lymph nodes was higher in the <jats:italic>Q<\/jats:italic> group. No significant differences were observed in disease\u2010free survival, local recurrence, or overall survival rate rates between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The participation of qualified surgeons in LAR is technically advantageous.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ags3.12763","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T03:45:30Z","timestamp":1702611930000},"page":"464-470","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Evaluation of the advantage of surgeons certified by the endoscopic surgical skill qualification system participating in laparoscopic low anterior rectal resection"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9062-6650","authenticated-orcid":false,"given":"Naruhiko","family":"Sawada","sequence":"first","affiliation":[{"name":"Digestive Disease Center Showa University Northern Yokohama Hospital  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0722-0343","authenticated-orcid":false,"given":"Tomonori","family":"Akagi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological and Pediatric Surgery Oita University  Oita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8078-0091","authenticated-orcid":false,"given":"Manabu","family":"Shimomura","sequence":"additional","affiliation":[{"name":"Hiroshima City North Medical Center Asa Citizens Hospital  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukitoshi","family":"Todate","sequence":"additional","affiliation":[{"name":"Department of Surgery Southern Tohoku General Hospital  Koriyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiko","family":"Nagakari","sequence":"additional","affiliation":[{"name":"Department of Digestive and General Surgery Juntendo University Urayasu Hospital  Urayasu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Takeshita","sequence":"additional","affiliation":[{"name":"Department of Surgery National Hospital Organization Nagasaki Medical Center  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Maruyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Niigata Cancer Center Hospital  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Takata","sequence":"additional","affiliation":[{"name":"Department of Surgery Nagano Municipal Hospital  Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuki","family":"Ichikawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery I, Graduate School of Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7210-7075","authenticated-orcid":false,"given":"Koya","family":"Hida","sequence":"additional","affiliation":[{"name":"Department of Surgery Kyoto University Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Iijima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery I, Graduate School of Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3850-2818","authenticated-orcid":false,"given":"Shigeki","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Division of Colorectal Surgery, Department of Surgery Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinobu","family":"Taketomi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery I, Graduate School of Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4169-6334","authenticated-orcid":false,"given":"Takeshi","family":"Naitoh","sequence":"additional","affiliation":[{"name":"Department of Lower Gastrointestinal Surgery Kitasato University School of Medicine  Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The EnSSURE Study Group Collaboratives in Japan Society of Laparoscopic Colorectal Surgery.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,14]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Cancer Registry and Statistics.Cancer Information Service National Center Japan. 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