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Hand-assisted laparoscopic surgery for left sided colorectal cancer: is quality of surgery related with experience?

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Summary

Introduction

Hand-assisted laparoscopic colectomy (HALC) is an alternative technique to conventional laparoscopic surgery: it is technically easier, learning curve, and operative time is shorter. Our aim was to determine how operative and postoperative results are affected gaining the experience.

Methods

A prospectively maintained database was used to identify all patients who underwent HALC for left-sided colorectal cancer by a single surgeon at the Institute of Oncology, Vilnius University, from April 2006 to December 2013. They were analyzed as two consecutive equal groups: first 100 and next 100 patients. Operative time and quality-related outcomes, including conversions, operative, and postoperative complications, length of hospital stay and reoperations were compared.

Results

A total of 200 HALC were performed. There were no significant differences between the two groups in terms of age, sex, cancer stage, body mass index, operative procedures, comorbidities, prior surgical experience. Conversion rate was similar between the two groups: 3 (2.9 %) versus 3 (2.9 %), p > 0.05. Group 2 showed significantly shorter operative time: 129 ± 49.5 versus 98 ± 35.8 min, p < 0.05; and length of hospital stay: 8.1 ± 4.3 versus 6.5 ± 3.2 days, p < 0.05. The rate of complications was not significantly higher in group 1: 14(14 %) versus 9 (9 %), p > 0.05.

Conclusions

HALC operative time and postoperative hospital stay decreased with surgeon experience. For quality-related outcomes, HALC had no learning curve.

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Authors and Affiliations

  1. Institute of Oncology, Vilnius University, Santariskiu Street, LT–08406, Vilnius, Lithuania

    A. Dulskas &  N. E. Samalavicius MD, PhD

  2. Faculty of Medicine, Center of Oncosurgery, Institute of Oncology, Clinic of Internal, Family Medicine and Oncology, Vilnius University, 1 Santariskiu str., LT–08406, Vilnius, Lithuania

    N. E. Samalavicius MD, PhD

  3. Department of Surgery, Gastrointestinal Unit, B.P. Koirala Institute of Health Sciences, Dharan, Nepal

    R. K. Gupta MD

  4. Department of Cardiovascular Disease, Vilnius University, Santariskiu Street 2, LT–08661, Vilnius, Lithuania

    V. Zabulis

  5. Second Department of Anesthesia, Intensive Care and Pain Management, Vilnius University Hospital Santariskiu Clinics, Santariskiu Street 2, LT–08661, Vilnius, Lithuania

    R. S. Samalavicius

  6. Faculty of Law, Law Philosophy and Law History Department, Mykolas Romeri University, Ateities Street 20, LT–08303, Vilnius, Lithuania

    J. Kutkauskiene

  7. Departament of Surgery, Medical Centre of Loira, Av. Loira. Caracas, Venezuela

    R. Escalante

Authors
  1. A. Dulskas
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  2. N. E. Samalavicius MD, PhD
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  3. R. K. Gupta MD
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  4. V. Zabulis
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  5. R. S. Samalavicius
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  6. J. Kutkauskiene
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  7. R. Escalante
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Correspondence to A. Dulskas.

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Dulskas, A., Samalavicius, N., Gupta, R. et al. Hand-assisted laparoscopic surgery for left sided colorectal cancer: is quality of surgery related with experience?. Eur Surg 47, 238–242 (2015). https://doi.org/10.1007/s10353-015-0341-9

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  • DOI: https://doi.org/10.1007/s10353-015-0341-9

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