The learning curve for the laparoscopic approach for colorectal cancer: a single institution's experience.

BACKGROUND

The purpose of this study was to evaluate the learning curve of the laparoscopic approach for colorectal cancer and generate a focused training program for more junior surgeons.

SUBJECTS AND METHODS

This study analyzed data from 100 consecutive laparoscopic surgeries for colorectal cancer between January 2009 and July 2010. The learning curve was compared between the first 50 surgeries (study group 1) and the subsequent 50 surgeries (study group 2).

RESULTS

Age, gender, mean body mass index, history of abdominal surgery, and tumor stage were not significantly different between the two study groups. Operative time decreased with increasing experience and reached a plateau after 23 patients. The operative time in study group 2 tended to be shorter than in study group 1 (P=.06). Other parameters including blood loss, average number of retrieved lymph nodes, conversion rate, and intraoperative complication rates were not different between the two study groups.

CONCLUSIONS

More junior surgeons can be safely trained if they are exposed to a focused training program. Supervision by an experienced surgeon and considerable experiences in open colorectal surgery are assets for an accelerated learning curve.