Accelerated learning curve for colorectal resection, open versus laparoscopic approach, can be attained with expert supervision
| Autor: | Fumio Konishi, Shingo Tsujinaka, Ken Mizokami, Kok-Yang Tan, Junichi Sasaki, Yutaka J. Kawamura, Toru Maeda |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Laparoscopic surgery medicine.medical_specialty medicine.medical_treatment Rectum Japan medicine Humans Laparoscopy Colectomy Aged medicine.diagnostic_test business.industry Teaching Mortality rate General surgery Internship and Residency Cancer medicine.disease Colorectal surgery Surgery Endoscopy medicine.anatomical_structure Colonic Neoplasms Female business Colorectal Surgery Learning Curve Abdominal surgery |
| Zdroj: | Surgical Endoscopy. 24:2850-2854 |
| ISSN: | 1432-2218 0930-2794 |
| Popis: | Laparoscopic colorectal resection (LCR) is gaining popularity. Nonetheless, open surgery remains an important technique. Thus, surgeons should be technically proficient in both open and laparoscopic surgery. One question however remains unanswered: Can training for open and LCR occur simultaneously? The objective of this paper is to review the learning curve for open and laparoscopic colon resection of one surgeon who underwent a rigorous training program. A review of consecutive patients who underwent surgery for colon and rectosigmoid junction cancers by one trainee surgeon was performed. This surgeon had completed his basic surgical residency but had limited experience in colorectal cancer surgery. In total, 75 patients were included in this study. All operations were supervised by at least one staff surgeon with experience of more than 300 LCR cases. The trainee surgeon was allowed to train in both laparoscopic and open colorectal resection simultaneously. Forty-three patients underwent laparoscopic resection, while 32 patients underwent open surgery. Age, gender, mean body mass index (BMI), preoperative risk, and history of past abdominal surgery showed no significant difference between laparoscopic and open groups. There were no differences in tumor stage [International Union against Cancer (UICC)] or tumor size (p = 0.068 and 0.228, respectively). The morbidity rate for open and laparoscopic surgery was 3.1% (1/32) and 4.7% (2/43), respectively (p = 0.484). Operation time decreased with increasing experience, and plateaued after 25 cases in the laparoscopic group and 22 cases in the open group. The learning curve for open cases was 11 cases, and 7 for laparoscopic surgery. Surgeons who have completed a basic surgical residency but have limited colorectal surgery experience can learn both open and laparoscopic colorectal surgery simultaneously in an effective manner under supervision by well-experienced surgeons. |
| Databáze: | OpenAIRE |
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