A Clinical Study about the Relation between the Experience of Opeartor and Postoperative Course after Subtotal Gastrectomy

Yoshihiro Moriwaki, Syunsuke Kobayashi, Hideki Yamakoshi, Yutaka Nagahori, Sinsuke Imai, Yasuhiro Kido, Chitaka Kasaoka

Department of Surgery,Fujisawa Municlpal Hospital

A clinical study on the risk and the compatibility of operation by new surgeons in terms of the training in surgical techniques. We reviewed the 871 gastric cancer cases treated in the Fujisawa Municipal Hospital for the past 23 years.The operator and the elder surgeon of operator or assistant was divided into 4 groups according to the postgraduate year of the surgeon (group A; <5 years, group B; 5∼9 years, group C; 10∼19 years, group D; 20 years∼). The surgical stress, postopereative course and the prognosis of the cases were examined respectively in the operator groups and in the elder surgeon groups. (1) Concerning to operative bleeding, duration of the operation,the interval of postoperative decompression with a nasogastric tube and postoperative fast, risk of postoperative complications, 5-year survival and the mode of recurrence,there was no difference among the operator groups at the curative cases of stage I, II and III. However, among the elder surgeon groups,there was significant difference (p=0.0481) in 5-year survival and that of group D was better, (2) concerning to the surgical stress, postopereative course and the prognosis of the cases, there was no difference among the operator groups and the elder surgeon groups at noncurative stage III and IV. In conclusion, under proper coaching there is no problem in operations by new surgeons concerning postoperative complications and long-term prognosis.

Key words
postoperative complication of the gastrectomy for gastric cancer, prognosis of the gastrectomy for gastric cancer, education of the surgical technique for fresh surgeons

Reprint requests
Yoshihiro Moriwaki Department of Surgery, Fuijisawa Municipal Hospital
2-6-1, Fujisawa, Fuiisawa-city, 251 JAPAN

Accepted
September 11, 1996

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