Laparoscopic-assisted colectomy : the learning curve.
Society of American Gastrointestinal Endoscopic Surgeons SAGES. Annual meeting. Orlando FL USA, 1995/03/11.
One hundred fifty consecutive laparoscopic-assisted colectomies performed by a surgical team were analyzed in an attempt to define a learning curve.
These colectomies performed by the Norfolk Surgical Group over a 24-month period, were divided chronologically into six groups of 25 patients each.
The groups were then compared to determine if any improvement in length of procedure, complication rate, conversion rate, or length of stay developed as experience increased.
Colon cancer and diverticular disease were the most common indications for surgery in all groups.
Right hemicolectomy, left colectomy, and low anterior resection accounted for the majority of procedures in all groups.
A significant decrease in mean operative time, from 250 min to 156 min over the first 35-50 cases was observed before leveling off at approximately 140 min for the remaining groups.
Intraoperative complications were low in all groups (range zero to two) and did not show any trend.
There was no statistically significant difference in the conversion rate (23.3% overall) among the six groups.
Length of stay decreased from 6 days in the first two groups to 5 days in the last four groups, although the difference was not statistically significant.
The learning curve for laparoscopic-assisted colectomies is longer than appreciated by many surgeons, requiring as many as 35-50 procedures to decrease operative time to baseline.
Mots-clés Pascal : Chirurgie, Laparoscopie, Colectomie, Apprentissage, Technique, Evolution, Résultat, Complication, Formation professionnelle, Homme, Côlon pathologie, Appareil digestif pathologie
Mots-clés Pascal anglais : Surgery, Laparoscopy, Colectomy, Learning, Technique, Evolution, Result, Complication, Occupational training, Human, Colonic disease, Digestive diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0028784
Code Inist : 002B25G02. Création : 01/03/1996.