초기학습단계 중 복강경 대장절제술 50예에 대한 전후기 비교 : 임상병리학적 결과를 중심으로

Abstract

Purpose: The present study was designed to investigate the clinicopathologic results of performing laparoscopic colorectal resection during a learning curve period.

Methods: A prospective analysis of 50 consecutive patients who underwent elective laparoscopic colorectal surgery was conducted between April 2006 and September 2006. We monitored the learning curve of one surgeon. The perioperative clinical results, complications and pathologic details were evaluated prospectively. The 50 patients were divided into two chronological groups (the 25 early cases and the 25 late cases). Statistical analysis between the two groups was performed to evaluate the different outcomes and with taking into account the progressively increasing experience.

Results: A total of 45 cases had colorectal cancer. The operative procedure was executed by the standard laparoscopic technique and according to the tumor location, with proper lymph node dissection. Curative resection was performed for the all malignant cases. The remaining 5 cases all involved benign disease. The overall complication and conversion rates were 12% and 6%, respectively. All the complications were treated conservatively. The pathologic outcomes for the malignant cases were acceptable, with no differences being manifested between the two groups. The complication rate and the length of stay were decreased in the late group.

Conclusion: Laparoscopic colorectal resection can be performed safely and effectively. The clinicopathologic outcomes were acceptable even though the cases of the present study were done during the learning curve period of a surgeon.