Browsing by Author "Gaete Dañobeitia, María Inés"

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    Consistency between POLARS and LARS scores regarding the incidence of low anterior resection syndrome in a Chilean population undergoing rectal surgery secondary to cancer in a high-volume hospital
    (2023) Gaete Dañobeitia, María Inés; Moreno, D. ; Iglesias, A. ; Navarro Subiabre, Francisco Fabián; Dreyse, J. ; Cerda, Jaime; Durán Espinoza, Valentina; Molina Pezoa, María Elena; Miguieles Cocco, Rodrigo Alfonso; Urrejola Schmied, Gonzalo Ignacio; Larach Kattan, José Tomás; Bellolio R., Felipe
    Aim: The aim of this work was to evaluate the concordance between the low anterior resection syndrome (LARS) and preoperative LARS (POLARS) scores regarding the incidence of LARS in a Chilean population undergoing rectal surgery for cancer in a high-volume hospital. Method: The LARS score questionnaire, following telephone requests, was used to determine the presence and severity of LARS. The POLARS score was calculated based on variables described previously. Correlations and qualitative and quantitative concordance were evaluated using Spearman's correlation coefficient, the kappa coefficient and the Bland–Altman plot with Lin's concordance correlation coefficient. Results: A total of 120 patients met the inclusion criteria: 37.5% underwent neoadjuvant radiotherapy, 61% underwent total mesorectal excision (TME) and 51.6% underwent ostomy. A total of 49% of patients did not present with LARS, whereas 28% had major LARS. The correlation between scales was poor, with a fair qualitative concordance to determine the presence/absence of LARS and a slight qualitative concordance to determine the degree of the intensity. The quantitative concordance was poor. Conclusion: In the Chilean population, concordance between the LARS and POLARS scores was qualitatively fair to determine the presence/absence of the disease and qualitatively slight to determine the degree of intensity. We do not suggest using the POLARS score in the perioperative period in the Chilean population deliberately, as the score may help to determine the presence/absence of LARS but cannot determine its degree of intensity. Additional evaluations are required to determine the factors contributing to the degree of agreement between the scales.
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    Home-based training for first-year surgery residents: learning to perform an open manual intestinal anastomosis with remote and asynchronous feedback
    (2024) Miguieles Schilling, Mariana Andrea; Montero Jaras, Isabella; Valencia Coronel, Brandon; Durán Espinoza, Valentina Alexandra; Gaete Dañobeitia, María Inés; Belmar Riveros, Francisca Andrea; Rodríguez, Natalie; Mena, Felipe; Escalona Vives, Gabriel; Bellolio Roth, Felipe; Jarry Trujillo, Cristian Ignacio; Varas Cohen, Julián Emanuel
    Purpose This study explores the feasibility of remote training for complex surgical skills through an at-home open manual intestinal anastomosis (MIA) program for 1 year surgery residents. Methods and procedures A quasi-experimental design assessed an open MIA training module. It included (1) an MIA video tutorial, tutored class, and in-person feedback, and (2) at-home training with remote asynchronous feedback. Trainees video-recorded and uploaded their MIA attempts to receive feedback through a digital platform. All program completions between July 2021 and October 2022 were included. Two evaluators, blind to the participants and to the timing of the videos, assessed residents’ performance using global (GRS) and procedure specific (SRS) ratings scales, and measured procedural time. Pre-post analysis utilized first and last uploaded videos. A satisfaction survey gauged residents’ perception. Non-parametric statistics were used (p < 0.05). Results Fourteen residents completed the training program. Pre-post video assessments showed a non-significant trend towards improved GRS and SRS scores, with decreased procedural time. Median GRS scores were 15.75 vs. 15.75 (p = 0.71), and SRS scores were 13.5 vs. 14.5 (p = 0.85). Procedural time decreased from 34 to 32.1 min (p = 0.40). Among survey respondents, 71% found feedback helpful for error correction and skill improvement, and 86% reported increased confidence in performing open MIA. Conclusion Implementing an at-home training program for complex surgical skills is feasible. Remote and asynchronous digital feedback holds promise for enhancing technical skills, though further research is necessary to understand the learning process, and additional training sessions may be needed.
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    Taking advantage of asynchronous digital feedback: development of an at‑home basic suture skills training program for undergraduate medical students that facilitates skills retention
    (2023) Belmar Riveros, Francisca; Gaete Dañobeitia, María Inés; Durán Espinoza, Valentina; Chelebifski Vargas, Slavka; Jarry Trujillo, Cristián; Ortiz Koh, Catalina; Escalona, Gabriel; Villagrán Gutiérrez, Ignacio Andrés; Alseidi, Adnan; Zamorano Rivera, Elga; Pimentel Muller, Fernando; Crovari Eulufi, Fernando; Varas Cohen, Julián; Pontificia Universidad Católica de Chile. Centro de Cirugía Experimental y Simulación. Departamento de Cirugía Digestiva; Pontificia Universidad Católica de Chile. Departamento de Cirugía Digestiva
    Purpose to date, there are no training programs for basic suturing that allow remote deliberate practice. This study seeks to evaluate the efectiveness of a basic suture skills training program and its 6-month skill retention applying unsupervised practice and remote digital feedback. Methods Fourth-year medical-student trainees reviewed instructional videos from a digital platform and performed unsu pervised practice as needed at their homes. When they felt competent, trainees uploaded a video of themselves practicing the skill. In<72 h, they received expert asynchronous digital feedback. The course had two theoretical stages and fve video-based assessments, where trainees performed diferent suturing exercises. For the assessment, a global (GRS) and specifc rating scale (SRS) were used, with a passing score of 20 points (max:25) and 15 (max:20), respectively. Results were compared to previously published work with in-person expert feedback (EF) and video-guided learning without feedback (VGL). A subgroup of trainees underwent a 6-month skills retention assessment. Results Two-hundred and forty-three trainees underwent the course between March and December 2021. A median GRS of 24 points was achieved in the fnal assessment, showing signifcantly higher scores (p<0.001) than EF and VGL (20.5 and 15.5, respectively). Thirty-seven trainees underwent a 6-month skills retention assessment, improving in GRS (23.38 vs 24.03, p value=0.06) and SRS (18.59 vs 19, p value=0.07). Conclusion It is feasible to teach basic suture skills to undergraduate medical students using an unsupervised training course with remote and asynchronous feedback through a digital platform. This methodology allows continuous training with the repetition of quality practice, personalized feedback, and skills retention at 6 months.