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Long-term Oncologic Outcomes of Laparoscopic Right Hemicolectomy During the Learning Curve Period

Comparative Study With Cases After the Learning Curve Period

Park, Eun Jung MD; Kim, Min Sung MD; Kim, Gangmi MD; Kim, Chang Hee MD; Hur, Hyuk MD; Min, Byung So MD; Baik, Seung Hyuk MD, PhD; Lee, Kang Young MD, PhD; Kim, Nam Kyu MD, PhD

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: February 2015 - Volume 25 - Issue 1 - p 52–58
doi: 10.1097/SLE.0000000000000016
Original Articles
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Background: This study aimed to assess the learning curve in laparoscopic right hemicolectomy and compare the long-term oncologic outcomes of the learning curve period.

Materials and Methods: We retrospectively reviewed 97 patients who underwent a laparoscopic right hemicolectomy by a single surgeon between July 2006 and January 2009. Among them, 87 patients, excluding patients with stage IV (n=10) disease, were evaluated for long-term oncologic outcomes. They were divided into 2 phases: phase 1 (the learning curve period) and phase 2 (the expert period). The cumulative sum method was used for estimating the learning curve.

Results: The learning curve was determined at the 42nd case. Patient characteristics and postoperative clinicopathologic outcomes were similar in both groups except for the operation time (212.5±65.0 min vs. 146.4±37.1 min; P<0.001) and length of stay (10.7±5.4 d vs. 8.4±2.9 d; P=0.015). The 5-year overall survival rates were similar in both groups throughout all stages. The 5-year disease-free survival rate of stage III disease in phase 2 (85%) was better than that of phase 1 (53.3%; P=0.046).

Conclusions: Laparoscopic right hemicolectomy during the learning curve period showed acceptable clinicopathologic outcomes. However, the 5-year disease-free survival rate was compromised in patients with stage III disease in phase I.

Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

The authors declare no conflicts of interest.

Reprints: Seung Hyuk Baik, MD, PhD, Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, 120-752, South Korea (e-mail: whitenoja@yuhs.ac)

Received May 21, 2013

Accepted September 30, 2013

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