Can community surgeons perform laparoscopic colorectal surgery with outcomes similar to tertiary care centres?
Bibliographic record
Abstract
INTRODUCTION: The use of the laparoscopic approach in colorectal surgery (LCS) is the subject of active debate. Studies demonstrating its safety and feasibility in tertiary care centres are now available. The aim of this study was to examine the results of LCS performed in a community hospital setting. METHODS: We prospectively studied 100 patients who underwent an LCS at the North Bay District Hospital (a 200-bed community hospital located 350 km away from the nearest tertiary care centre). All operations were performed by 2 community surgeons who transitioned themselves from an open to a laparoscopic approach. RESULTS: Between October 2000 and December 2003, 100 patients (56 women and 44 men, mean age 64 yr) underwent an LCS for benign (n = 54) and malignant (n = 46) disease. Median operating time was 165 minutes (range 70350 min), and the conversion rate was 10%. The intraoperative complication rate was 3%. There were 10 major postoperative complications and 14 minor postoperative complications. There was no intraoperative mortality and one 30-day mortality secondary to cardiogenic shock. The median length of stay was 4.5 days (range 245 d). At a mean follow-up of 18 months, no trocar site or wound recurrences were noted. The mean number of resected lymphnodes was 10.6. CONCLUSION: Our study suggests that it is possible for community surgeons to transition themselves from an open to a laparoscopic approach and to perform LCS with outcomes similar to those of tertiary care centres.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.011 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".