title: Surgical outcomes after preceptored laparoscopic colorectal surgery: results of a Brazilian preceptorship program.
abstract: OBJECTIVE
  Safety of laparoscopic colectomy education methods remains unknown. This study aimed at comparing the outcomes of patients undergoing preceptored laparoscopic colectomy with patients operated on by the same preceptor.
  
  
  METHODS
  A prospective analysis of 30 pre-ceptored operations performed by nine surgeons (PD group) between 2006 and 2008 was conducted. Data of 30 operations matched for diagnosis and surgery type conducted by the same preceptor (P group) were evaluated.
  
  
  RESULTS
  Median age was 56.2 (26-80) and 55.2 (22-81) respectively in P and PD group (p = 0.804). Eleven (36.7%) were male in P group, 16 (53.3%) in PD group (p = 0.194). Preceptored operations were not significantly longer than operations performed by the preceptor (198 vs. 156 min)--p = 0.072. Length of hospital stay did not differ [4 days (3-12) in P group, and 5 (3-15) in PD group, p = 0.296]. Conversion occurred in 4 cases in PD and in 2 in P group (p = 0.389). Morbidity was similar (23.3% in P and 26.7% in PD group). One patient from P and two from PD group needed reoperation. No deaths occurred.
  
  
  CONCLUSIONS
  Laparoscopic colorectal surgery preceptorship programs in surgeon learner's place are safe. Surgeons' introduction through basic and hands-on courses is required for skills acquisition needed to minimize adverse outcomes.
authors.affiliation: Discipline of Coloproctology, Department of Gastroenterology, University of Sao Paulo Medical School, Sao Paulo, Brazil. sergioed@terra.com.br
authors.forename: Sergio Eduardo Alonso
authors.initials: SE
authors.lastname: Araujo
authors.forename: Victor Edmond
authors.initials: VE
authors.lastname: Seid
authors.forename: Rodrigo Blanco
authors.initials: RB
authors.lastname: Dumarco
authors.forename: Caio Sergio Rizkallah
authors.initials: CS
authors.lastname: Nahas
authors.forename: Sergio Carlos
authors.initials: SC
authors.lastname: Nahas
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003107:Colorectal Surgery / Q000193:education*; D004501:Education, Medical; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011231:Preceptorship; D016896:Treatment Outcome