Table 6 Surgeons' qualification and control measures for surgical quality within the trials included in the meta-analysis
Author | year | references | Surgeons‘ qualification | Quality control |
|---|---|---|---|---|
Cai | 2011 | Cai, Wei et al. [19] | One single surgeon for the laparoscopic approach Two other surgeons for the open approach | N/a |
Hu | 2016 | Hu, Huang et al. [22] Hu, Huang et al. [26] | Surgeons Have performed at least 50 distal gastrectomies with D2 lymphadenectomy using open and laparoscopic approaches Were determined to be qualified surgeons by the CLASS academic committee on the basis of the evaluation of unedited videos of both their open and laparoscopic gastrectomy with D2 lymphadenectomy procedures Institution At least 300 gastrectomies for patients with AGC annually at each institute | Surgical quality control was maintained by using mandatory intraoperative photographs that identified specific surgical fields, the resection margin of the specimen, and the abdominal incision Five photos were required to verify the surgical quality of the D2 lymph node clearance as follows: (1) The area between the pancreatic tail and the lower pole of the spleen (2) The pancreatic head and infrapyloric area (3) The right side of the suprapancreatic area (4) The left side of the suprapancreatic area (5) The lesser curvature area These photos were reviewed, and feedback on the assessment was regularly provided to the investigators |
Park | 2018 | Park, Yoon et al. [31] Kim, Park et al. [27] Kim, Park et al. [20] Nam, Kim et al. [21] | Surgeons Had performed at least 30 LADG procedures before the start of this study | To standardize the open and laparoscopic D2 lymphadenectomy procedures, all surgeons attended 10 video seminars to observe unedited videos of the surgical procedure before the start of this trial. To evaluate the D2 lymphadenectomies, we created a list of checkpoints to determine their success. |
Shi | 2018 | Shi, Xu et al. 2017 | Surgeons Had performed either LAG or OG with D2 lymphadenectomy in more than 50 cases Before the trial, all participating surgeons reviewed and agreed to the technical details for the surgical procedures Institution Center with significant experience in gastric cancer surgery | Surgical quality control was maintained by regular reviews of the recorded videos of LAGs and the photographs of OGs Results of the assessments were provided to each surgeon |
Wang | 2018 | Wang, Xing et al. 2018 | Surgeons Specialized in gastric surgery Have already conducted at least 60 ODG and 60 LADG with D2 lymphadenectomy previously Institutions At least 80 gastrectomies/institution for advanced gastric cancer patients each year | Intraoperative photographs and unedited videos were mandatory required and monitored by the study chair to control the surgical quality Ten photos were uploaded for each participant. Among them, five pictures were taken for lymph node dissection fields, four for the lesion and resection margins of specimens, and one for the abdominal incision |