Impact of laparoscopic surgical experience on the learning curve of robotic rectal cancer surgery

被引:14
作者
Noh, Gyoung Tae [1 ]
Han, Myunghyun [1 ]
Hur, Hyuk [2 ]
Baik, Seung Hyuk [2 ]
Lee, Kang Young [2 ]
Kim, Nam Kyu [2 ]
Min, Byung Soh [2 ,3 ]
机构
[1] Ewha Womans Univ, Sch Med, Dept Surg, Seoul, South Korea
[2] Yonsei Univ, Coll Med, Dept Surg, Seoul, South Korea
[3] Yonsei Univ, Coll Med, Severance Hosp, Dept Surg, 50-1 Yonsei Ro, Seoul 03722, South Korea
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2021年 / 35卷 / 10期
关键词
Learning curve; Robotic surgery; Rectal cancer; Laparoscopic experience; TOTAL MESORECTAL EXCISION; LOW ANTERIOR RESECTION; COUNCIL CLASICC TRIAL; MULTIDIMENSIONAL-ANALYSIS; SINGLE-INCISION; RIGHT HEMICOLECTOMY; FOLLOW-UP; OUTCOMES; CONVERSION; LESSONS;
D O I
10.1007/s00464-020-08059-5
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Robotic surgery has advantages in terms of the ergonomic design and expectations of shortening the learning curve, which may reduce the number of patients with adverse outcomes during a surgeon's learning period. We investigated the differences in the learning curves of robotic surgery and clinical outcomes for rectal cancer among surgeons with differences in their experiences of laparoscopic rectal cancer surgery. Methods Patients who underwent robotic surgery for colorectal cancer were reviewed retrospectively. Patients were divided into five groups by surgeons, and their clinical outcomes were analyzed. The learning curve of each surgeon with different volumes of laparoscopic experience was analyzed using the cumulative sum technique (CUSUM) for operation times, surgical failure (open conversion or anastomosis-related complications), and local failure (positive resection margins or local recurrence within 1 year). Results A total of 662 patients who underwent robotic low anterior resection (LAR) for rectal cancer were included in the analysis. Number of laparoscopic LAR cases performed by surgeon A, B, C, D, and E prior to their first case of robotic surgery were 403, 40, 15, 5, and 0 cases, respectively. Based on CUSUM for operation time, surgeon A, B, C, D, and E's learning curve periods were 110, 39, 114, 55, and 23 cases, respectively. There were no significant differences in the surgical and oncological outcomes after robotic LAR among the surgeons. Conclusions This study demonstrated the limited impact of laparoscopic surgical experience on the learning curve of robotic rectal cancer surgery, which was greater than previously reported curves.
引用
收藏
页码:5583 / 5592
页数:10
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