Training period in laparoscopic colorectal surgery: A case-matched comparative study with open surgery

M. Braga, A. Vignali, W. Zuliani, G. Radaelli, L. Gianotti, G. Toussoun, V. Carlo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Thorough training is essential to the success of colorectal laparoscopic surgery (LPS). The aim of this study was to evaluate the results of a 3-month training period in LPS. Methods: Before beginning the study, the surgical team attended several courses of LPS and spent a long time working at a large animal facility to perfect laparoscopic techniques. Twenty-six consecutive patients underwent LPS in a 3-month training period. Controls (n = 26) who underwent open colorectal surgery (LPT) were selected to match the LPS patients for age, gender, primary disease, type of surgery, comorbidity, and nutritional status. Results: Conversion to open surgery was necessary in one patient (3.8%). The operative time was 1 h longer for LPS than LPT (p <0.001). The mean number of lymph nodes harvested was 17 in LPS and 18 in LPT (p = 0.76). The first flatus (p <0.02) and bowel movement (p <0.002) occurred earlier in the LPS group. The postoperative infection rate was 11.5% for LPS and 19.2% for LPT (p = 0.33). Two anastomotic leaks occurred in each group. The mean postoperative hospital stay was 9.6 days (standard deviation [SD], 2.6) for LPS and 11.0 days (SD, 5.2) for LPT (p = 0.68). Recovery of postoperative physical performance and social life occurred earlier in the LPS than the LPT group (p <0.001). At 1-year follow-up, no difference was found in terms of cancer recurrence or long-term complications. Conclusion: Oncologic results and postoperative morbidity were comparable for LPS and LPT. LPS allows a faster postoperative recovery.

Original languageEnglish
Pages (from-to)31-35
Number of pages5
JournalSurgical Endoscopy and Other Interventional Techniques
Volume16
Issue number1
DOIs
Publication statusPublished - 2002

Keywords

  • Bowel function
  • Colorectal surgery
  • Laparoscopy
  • Learning curve
  • Postoperative morbidity
  • Training

ASJC Scopus subject areas

  • Surgery

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