Registrar Performances in MIDP

Study Overview
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Brief Summary
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This study aimed to determine whether registrar involvement in minimally invasive distal pancreatectomy (MIDP) was associated with adverse outcomes.

Detailed Description
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From January 2009 to March 2020, data of all consecutive patients requiring distal pancreatectomy in our public tertiary hospital were prospectively collected and retrospectively analyzed. Registrars were progressively involved for MIDP since 2009 and their experience was: < 5 open pancreatic resections, < 5 MIDP and at least 30 advanced minimally invasive gastrointestinal resections. Outcome of patients who underwent either distal pancreatectomy by the consultant or registrars were compared. Our primary outcome was the conversion rate. The secondary outcomes were 90-days postoperative outcomes including CR-POPF defined and classified according to the 2016 ISGPF definition.

Official Title
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Registrar Performance in Laparoscopic Distal Pancreatectomy and Its Effect on Postoperative Outcomes

Conditions
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Minimally Invasive Distal Pancreatectomy

Intervention / Treatment
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* Procedure: Minimally invasive distal pancreatectomy


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: - Patients who underwent minimally invasive distale pancreatectomy for benign or borderline pathology between 2009-2020 Exclusion criteria: open distal pancreatectomy minimally invasive distal pancreatectomy for pancreatic cancer 20 first consecutive patients operated on by the consultant (learning curve)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group 1 (Registrar)<br>Group 1 (Registrar): Patients who underwent minimally invasive distale pancreatectomy for benign or borderline pathology operated on by a registrar (young specialist surgeon) | Procedure: Minimally invasive distal pancreatectomy<br>* Minimally invasive distal pancreatectomy<br>|
| Group 2 (Consultant)<br>Group 2 (Consultant): Patients who underwent minimally invasive distale pancreatectomy for benign or borderline pathology operated on by a consultant (expert) | Procedure: Minimally invasive distal pancreatectomy<br>* Minimally invasive distal pancreatectomy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| open conversion rate | Necessity to swith from minimally invasive approach to open approach during laparoscopy | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Duration of surgery | Duration of surgery | 1 day | 
| Intraoperative bloodloss | Intraoperative bloodloss | 1 day | 
| Intraoperative transfusion | Intraoperative transfusion | 1 day | 
| severe complications Clavien Dindo>3 | severe complications Clavien Dindo>3 | 90 days postoperative | 
| postoperative complications | postoperative complications | 90 days postoperative | 
| clinically relevant postoperative fistula | clinically relevant postoperative fistula (2016 ISGPF definition) | 90 days postoperative | 
| lenght of hospital stay | lenght of hospital stay | 90 days postoperative | 
| readmission rate | readmission rate | 90 days postoperative | 
| reoperation rate | reoperation rate | 90 days postoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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surgery, Benign or borderline pathology (non-pancreatic cancer), laparoscopy, registrar, postoperative outcomes, pancreatectomy, pancreas