RESUMO
INTRODUCTION: There has been a constant increase in the number of published surgical videos with preference for open-access sources, but the proportion of videos undergoing peer-review prior to publication has markedly decreased, raising questions over quality of the educational content presented. The aim of this study was the development and validation of a standard framework for the appraisal of surgical videos submitted for presentation and publication, the LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) video assessment tool. METHODS: An international committee identified items for inclusion in the LAP-VEGaS video assessment tool and finalised the marking score utilising Delphi methodology. The tool was finally validated by anonymous evaluation of selected videos by a group of validators not involved in the tool development. RESULTS: 9 items were included in the LAP-VEGaS video assessment tool, with every item scoring from 0 (item not presented in the video) to 2 (item extensively presented in the video), with a total marking score ranging from 0 to 18. The LAP-VEGaS video assessment tool resulted highly accurate in identifying and selecting videos for acceptance for conference presentation and publication, with high level of internal consistency and generalisability. CONCLUSIONS: We propose that peer review in adherence to the LAP-VEGaS video assessment tool could enhance the overall quality of published video outputs.
Assuntos
Lista de Checagem , Avaliação Educacional , Guias como Assunto , Laparoscopia/normas , Gravação em Vídeo/normas , Humanos , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
PURPOSE: We investigated the association between the Revised Cardiac Risk Index (RCRI) and postoperative outcomes in patients undergoing non-cardiac surgery. METHODS: The predictive value of the RCRI for the risk of perioperative complications, length of hospital stay and hospital cost were evaluated from a prospective cohort of 119 patients aged ≥65 years undergoing elective major digestive, breast or vascular surgery. RESULTS: Comparing three groups RCRI 0, 1 and ≥2, the morbidity rates were 0, 30 and 68 %; the median length of hospitalization was 5, 14 and 28 days; and the median cost was 665,000, 1,480,000 and 2,160,000 yen, respectively. The mortality rate was 0 % in all groups. The RCRI 0 group included only non-high-risk (breast and peripheral vascular) surgeries. In addition, comparing the two groups by excluding non-high-risk surgeries (RCRI 1 and ≥2), the median morbidity rates were 31 and 67 %, the median length of hospitalization was 15 and 28 days, and the median cost was 1,550,000 and 2,130,000 yen, respectively. The RCRI score was the only independent predictor of the perioperative complications. CONCLUSIONS: In the case of non-cardiac surgery, the RCRI can identify patients at higher risk of perioperative complications, a prolonged hospital stay and higher hospital cost.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Procedimentos Cirúrgicos Eletivos , Complicações Pós-Operatórias/epidemiologia , Medição de Risco/métodos , Risco , Procedimentos Cirúrgicos Vasculares , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Comorbidade , Procedimentos Cirúrgicos do Sistema Digestório/economia , Procedimentos Cirúrgicos Eletivos/economia , Feminino , Custos Hospitalares , Humanos , Tempo de Internação , Masculino , Mastectomia , Complicações Pós-Operatórias/economia , Valor Preditivo dos Testes , Estudos Prospectivos , Procedimentos Cirúrgicos Vasculares/economiaRESUMO
The current status of laparoscopic surgery and its indications for colorectal cancer are described. According to multi-institutional registry by the Japanese Society of Endoscopic Surgeons, the number of laparoscopic surgeries for advanced colorectal cancer has been increasing during the last couple years. The short- and long-term results of laparoscopic surgery for pT1 or pT2 colon cancer are favourable, and laparoscopic surgery could be a standard procedure for such cases. However, the indications for pT3/T4 cancer remain controversial due to limited length of follow-up. A multi-centre randomised controlled trial (RCT) comparing open with laparoscopic surgery for advanced (T3/T4) cancer is to start in autumn this year. Laparoscopic surgery for such cases should be confined to trial cases. Laparoscopic surgery for rectal cancer is feasible; however, it is associated with higher anastomotic leak rates. Issues on education and medical costs need to be resolved.