Original Article

J Minim Invasive Surg 2008; 11(2): 93-99

Published online December 15, 2008

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

초기학습단계 중 복강경 대장절제술 50예에 대한 전후기 비교: 임상병리학적 결과를 중심으로

김법우ㆍ백승혁ㆍ김진수ㆍ허혁ㆍ이강영ㆍ손승국ㆍ조장환

연세대학교 의과대학 외과학교실

Comparison between the Initial 25 Cases and the Last 25 Cases of Laparoscopic Colorectal Resection during a Learning Period and According to the Clinicopathologic Outcomes

Bup Woo Kim, M.D., Seung Hyuk Baik, M.D., Jin Soo Kim, M.D., Hyuk Hur, M.D., Kang Young Lee, M.D., Seung Kook Sohn, M.D., Chang Hwan Cho, M.D.

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: The present study was designed to investigate the clinicopathologic results of performing laparoscopic colorectal resection during a learning curve period. Methods: A prospective analysis of 50 consecutive patients who underwent elective laparoscopic colorectal surgery was conducted between April 2006 and September 2006. We monitored the learning curve of one surgeon. The perioperative clinical results, complications and pathologic details were evaluated prospectively. The 50 patients were divided into two chronological groups (the 25 early cases and the 25 late cases). Statistical analysis between the two groups was performed to evaluate the different outcomes and with taking into account the progressively increasing experience. Results: A total of 45 cases had colorectal cancer. The operative procedure was executed by the standard laparoscopic technique and according to the tumor location, with proper lymph node dissection. Curative resection was performed for the all malignant cases. The remaining 5 cases all involved benign disease. The overall complication and conversion rates were 12% and 6%, respectively. All the complications were treated conservatively. The pathologic outcomes for the malignant cases were acceptable, with no differences being manifested between the two groups. The complication rate and the length of stay were decreased in the late group. Conclusion: Laparoscopic colorectal resection can be performed safely and effectively. The clinicopathologic outcomes were acceptable even though the cases of the present study were done during the learning curve period of a surgeon.

Keywords Learning curve, Laparoscopic colorectal resection, Laparoscopy

Article

Original Article

J Minim Invasive Surg 2008; 11(2): 93-99

Published online December 15, 2008

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

초기학습단계 중 복강경 대장절제술 50예에 대한 전후기 비교: 임상병리학적 결과를 중심으로

김법우ㆍ백승혁ㆍ김진수ㆍ허혁ㆍ이강영ㆍ손승국ㆍ조장환

연세대학교 의과대학 외과학교실

Comparison between the Initial 25 Cases and the Last 25 Cases of Laparoscopic Colorectal Resection during a Learning Period and According to the Clinicopathologic Outcomes

Bup Woo Kim, M.D., Seung Hyuk Baik, M.D., Jin Soo Kim, M.D., Hyuk Hur, M.D., Kang Young Lee, M.D., Seung Kook Sohn, M.D., Chang Hwan Cho, M.D.

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: The present study was designed to investigate the clinicopathologic results of performing laparoscopic colorectal resection during a learning curve period. Methods: A prospective analysis of 50 consecutive patients who underwent elective laparoscopic colorectal surgery was conducted between April 2006 and September 2006. We monitored the learning curve of one surgeon. The perioperative clinical results, complications and pathologic details were evaluated prospectively. The 50 patients were divided into two chronological groups (the 25 early cases and the 25 late cases). Statistical analysis between the two groups was performed to evaluate the different outcomes and with taking into account the progressively increasing experience. Results: A total of 45 cases had colorectal cancer. The operative procedure was executed by the standard laparoscopic technique and according to the tumor location, with proper lymph node dissection. Curative resection was performed for the all malignant cases. The remaining 5 cases all involved benign disease. The overall complication and conversion rates were 12% and 6%, respectively. All the complications were treated conservatively. The pathologic outcomes for the malignant cases were acceptable, with no differences being manifested between the two groups. The complication rate and the length of stay were decreased in the late group. Conclusion: Laparoscopic colorectal resection can be performed safely and effectively. The clinicopathologic outcomes were acceptable even though the cases of the present study were done during the learning curve period of a surgeon.

Keywords: Learning curve, Laparoscopic colorectal resection, Laparoscopy

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