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

Title
Impact of laparoscopic surgical experience on the learning curve of robotic rectal cancer surgery
Authors
Noh G.T.Han M.Hur H.Baik S.H.Lee K.Y.Kim N.K.Min B.S.
Ewha Authors
노경태한명현
SCOPUS Author ID
노경태scopus; 한명현scopus
Issue Date
2021
Journal Title
Surgical Endoscopy
ISSN
0930-2794JCR Link
Citation
Surgical Endoscopy vol. 35, no. 10, pp. 5583 - 5592
Keywords
Laparoscopic experienceLearning curveRectal cancerRobotic surgery
Publisher
Springer
Indexed
SCIE; SCOPUS scopus
Document Type
Article
Abstract
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. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
DOI
10.1007/s00464-020-08059-5
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의료원 > 의료원 > Journal papers
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