Effectiveness and safety of a laparoscopic training system combined with modified reconstruction techniques for total laparoscopic distal gastrectomy

Table 1 Patient clinicopathological characteristics

Characteristics	Trainee surgeon	Trainer surgeon	P value
Age in yr
Median	68.5 (37-83)	69.6 (42-90)	0.630
< 80	44 (84.6%)	31 (77.5%)	0.794
≥ 80	8 (15.4%)	9 (22.5%)
Sex
Male	32 (61.5%)	23 (57.5%)	0.830
Female	20 (38.5%)	17 (42.5%)
BMI in kg/m
Median	22.01 (14.98-36.00)	23.11 (18.67-32.56)	0.145
< 25	43 (82.7%)	30 (75.0%)	0.440
≥ 25	9 (17.3%)	10 (25.0%)
ASA
1	20 (38.5%)	13 (32.5%)	0.793
2	29 (55.8%)	24 (60.0%)
3	3 (5.7%)	3 (7.5%)
Previous abdominal surgery
Yes	14 (26.9%)	8 (20%)	0.472
No	38 (73.1%)	32 (80%)
pT
T1	42 (80.8%)	22 (55.0%)	0.004
T2	3 (5.8%)	5 (12.5%)
T3	6 (11.5%)	4 (10%)
T4	1 (1.9%)	9 (22.5%)
pStage
IA	35 (67.3%)	17 (42.5%)	0.017
IB	7 (13.5%)	6 (15%)
IIA	5 (9.6%)	3 (7.5%)
IIB	4 (7.7%)	3 (7.5%)
IIIA	1 (1.9%)	8 (20%)
IIIB	0	1 (2.5%)
IIIC	0	2 (5%)

Data are expressed as the median (range) or number of patients. BMI: Body mass index; ASA: American Society of Anesthesiologists.

Table 2 Surgical outcomes

Items	Trainee surgeon	Trainer surgeon	P value
LN dissection
D1+	43 (82.7%)	25 (62.5%)	0.034
D2	9 (17.3%)	15 (37.5%)
Combined organ resection	4 (7.7%)	2 (5%)	0.568
Cholecystectomy	4	0
Appendicectomy	0	1
Colectomy	0	1
Blood loss	26 (5-170)	23 (3-125)	0.566
Conversion to open procedure	0	0
Operation time in min
Median (range)	270 (199-512)	239 (154-375)	0.002
Harvested LNs, number
Median (range)	39 (14-86)	39 (14-70)	0.989
Postoperative hospital stays in d
Median (range)	13.38 (7-60)	12.70 (7-27)	0.720

Data are expressed as the median (range) or number of patients. LN: Lymph node.

Table 3 Lymphadenectomy and reconstruction outcome

Items	Trainee surgeon	Trainer surgeon	P value
Lymphadenectomy
Infrapyloric LNs	58.8 (27-135)	42.0 (19-85)	0.004
Suprapyloric LNs	18.8 (4-40)	10.6 (3-24)	0.001
Great Curvature LNs	17.7 (8-34)	12.3 (6-32)	0.004
Suprapancreatic LNs	41.0 (23-82)	28.4 (17-51)	0.001
Along lesser curvature LNs	16.6 (7-36)	14.1 (7-34)	0.213
GI reconstruction	19.0 (11-37)	18.9 (11-39)	0.988

Data are expressed as the median (range). LN: Lymph node; GI: Gastrointestinal.

Table 4 Postoperative complications

Items	Trainee surgeon	Trainer surgeon	P value
Anastomotic leakage	0	0	1.000
Anastomotic bleeding	1 (1.9%)	0	0.497
Anastomotic stenosis	0	0	1.000
Intra-abdominal abscess	2 (3.8%)	1 (2.4%)	0.683
Pancreatic fistula	1 (1.9%)	1 (2.4%)	1.000
Ileus	0	0	1.000
Mortality	0	0	1.000

Data are expressed as number of patients. Clavien–Dindo grade 2 or higher.