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KMID : 0914820150150010029
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Journal of the Korean Gastric Cancer Association
2015 Volume.15 No. 1 p.29 ~ p.38
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Lessons Learned from a Comparative Analysis of Surgical Outcomes of and Learning Curves for Laparoscopy-Assisted Distal Gastrectomy
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Moon Jun-Seok
Park Man-Sik
Kim Jong-Han
Jang You-Jin
Park Sung-Soo
Mok Young-Jae
Kim Seung-Joo
Kim Chong-Suk
Park Seong-Heum
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Abstract
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Purpose: Before expanding our indications for laparoscopic gastrectomy to advanced gastric cancer and adopting reduced port laparoscopic gastrectomy, we analyzed and audited the outcomes of laparoscopy-assisted distal gastrectomy (LADG) for adenocarcinoma; this was done during the adoptive period at our institution through the comparative analysis of short-term surgical outcomes and learning curves (LCs) of two surgeons with different careers.
Materials and Methods: A detailed comparative analysis of the LCs and surgical outcomes was done for the respective first 95 and 111 LADGs performed by two surgeons between July, 2006 and June, 2011. The LCs were fitted by using the non-linear ordinary least squares estimation method.
Results: The postoperative morbidity and mortality rates were 14.6% and 0.0%, respectively, and there was no significant difference in the morbidity rates (12.6% vs. 16.2%, P=0.467). More than 25 lymph nodes were retrieved by each surgeon during LADG procedures. The LCs of both surgeons were distinct. In this study, a stable plateau of the LC was not achieved by both surgeons even after performing 90 LADGs.
Conclusions: Regardless of the experience with gastrectomy or laparoscopic surgery for other organs, or the age of surgeon, the outcome was quite acceptable; the learning process differ according to the surgeon’s experience and individual characteristics.
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KEYWORD
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Laparoscopy, Gastrectomy, Learning curve, Treatment outcome
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