Seniors Have a Better Learning Curve for Laparoscopic Colorectal Cancer Resection


Purpose: This study was designed to evaluate the outcomes of laparoscopic colorectal resection in a period of learning curve completed by surgeons with different experience and aptitudes with a view to making clear whether seniors had a better learning curve compared with juniors.
Methods: From May 2010 to August 2012, the first twenty patients underwent laparoscopic colorectal resection completed by each surgeon were selected for analysis retrospectively. A total of 240 patients treated by 5 seniors and 7 juniors were divided into the senior group (n=100) and the junior group (n=140). The short-term outcomes of laparoscopic surgery of the two groups were compared.
Results: The mean numbers of lymph nodes harvested were 21.2±11.0 in the senior group and 17.3±11.5 in the junior group (p=0.010); The mean operative times were 187.9±60.0min as comparedto 231.3±55.7 min (p=0.006), and blood loss values were 177.0±100.7ml and 234.0±185ml, respectively (p=0.001); Conversion rate in the senior group was obviously lower than in the junior group (10.0% vs 20.7%, p=0.027) and the mean time to passing of first flatus were 3.3±0.9 and 3.8±0.9 days (p=0.001). For low rectal cancer, the sphincter preserving rates were 68.7% and 35.3% (p=0.027).
Conclusions: Seniors could perform laparoscopic colorectal resection with relatively better oncological outcomes and quicker recovery, and seniors could master the laparoscopic skill more easily and quickly. Seniors had a better learning curve for laparoscopic colorectal cancer resection compared to juniors.