Learning curve for hand-assisted laparoscopic D2 radical gastrectomy |
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Authors: | Jia-Qing Gong Yong-Kuan Cao Yong-Hua Wang Guo-Hu Zhang Pei-Hong Wang Guo-De Luo |
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Institution: | Jia-Qing Gong, Yong-Kuan Cao, Yong-Hua Wang, Guo-Hu Zhang, Pei-Hong Wang, Guo-De Luo, Center of General Surgery, the People’s Liberation Army General Hospital of Chengdu Command, Chengdu 610083, Sichuan Province, China |
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Abstract: | AIM:To describe the learning curves of hand-assisted laparoscopic D2 radical gastrectomy(HALG) for the treatment of gastric cancer.METHODS:The HALG surgical procedure consists of three stages:surgery under direct vision via the port for hand assistance,hand-assisted laparoscopicsurgery,and gastrointestinal tract reconstruction.According to the order of the date of surgery,patients were divided into 6 groups(A-F) with 20 cases in each group.All surgeries were performed by the same group of surgeons.We performed a comprehensive and indepth retrospective comparative analysis of the clinical data of all patients,with the clinical data including general patient information and intraoperative and postoperative observation indicators.RESULTS:There were no differences in the basic information among the patient groups(P 0.05).The operative time of the hand-assisted surgery stage in group A was 8-10 min longer than the other groups,with the difference being statistically significant(P = 0.01).There were no differences in total operative time between the groups(P = 0.30).Postoperative intestinal function recovery time in group A was longer than that of other groups(P = 0.02).Lengths of hospital stay and surgical quality indicators(such as intraoperative blood loss,numbers of detected lymph nodes,intraoperative side injury,postoperative complications,reoperation rate,and readmission rate 30 d after surgery) were not significantly different among the groups.CONCLUSION:HALG is a surgical procedure that can be easily mastered,with a learning curve closely related to the operative time of the hand-assisted laparoscopic surgery stage. |
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Keywords: | Learning curve Gastric cancer Hand-assisted laparoscopic D2 radical gastrectomy Operative time Surgical quality indicators |
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