Initial Experiences with a Laparoscopic Colorectal Resection: a Comparison of Short-term Outcomes for 50 Early Cases and 51 Late Cases. |
Seon, Jang Won , Huh, Jung Wook , Cho, Sang Hyuk , Joo, Jae Kyoon , Kim, Hyeong Rok , Kim, Young Jin |
Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, Korea. jwhuh@hotmail.com |
|
|
|
Abstract |
PURPOSE The present study aimed to investigate the safety and the feasibility of laparoscopic colorectal surgery performed by a surgeon during a learning period. METHODS Between April and December 2008, 101 consecutive patients with colorectal cancers underwent laparoscopic surgery by one colorectal surgeon who previously had no experience with laparoscopic colorectal surgery. Standard laparoscopy with a lymphadenectomy using a 5-port technique was performed according to the tumor location. The patients were divided into two chronological groups: 50 cases early in learning period (early cases) and 51 cases later in the learning period (late cases). RESULTS The operations were 29 right hemicolectomies, 9 left hemicolectomies, 18 anterior resections, 35 low anterior resections, 6 intersphincteric resections, 2 abdominoperineal resections, and 2 Hartmann's operation. There were 7 conversions (6.9%). The median operating time was 205 (range, 95-385) min, and the median blood loss was 258 (50-800) mL. The median times to flatus per anus and to feeding of soft diet were 2 (1-5) and 4 (2-13) days, respectively. The median hospital stay was 9 (6-27) days. There were 21 postoperative complications, including 7 anastomotic complications (3 leakages, 3 abscesses, and 1 stenosis). The median number of lymph nodes harvested was 20 (4-65). The operating time, blood loss, and complication rates were significantly decreased in the late group. CONCLUSION Our initial experience with laparoscopic colorectal surgery appears to have acceptable perioperative results and short-term oncologic outcomes, which improved with the experience of the surgeon. |
Key Words:
Colorectal cancer; Laparoscopic surgery; Learning curve |
|