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

A. Dulskas, N. E. Samalavicius, R. K. Gupta, V. Zabulis, R. S. Samalavicius, J. Kutkauskiene, R. Escalante

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)238-242
Number of pages5
JournalEuropean Surgery - Acta Chirurgica Austriaca
Volume47
Issue number5
DOIs
Publication statusPublished - Oct 15 2015

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Hand-Assisted Laparoscopy
Colectomy
Colorectal Neoplasms
Operative Time
Hand
Length of Stay
Learning Curve
Operative Surgical Procedures
Reoperation
Laparoscopy
Comorbidity
Body Mass Index
Databases
Neoplasms

Keywords

  • Colorectal cancer
  • Hand-assisted laparoscopic surgery
  • Laparoscopic left-sided colectomy
  • Outcomes

ASJC Scopus subject areas

  • Surgery

Cite this

Hand-assisted laparoscopic surgery for left sided colorectal cancer : is quality of surgery related with experience? / Dulskas, A.; Samalavicius, N. E.; Gupta, R. K.; Zabulis, V.; Samalavicius, R. S.; Kutkauskiene, J.; Escalante, R.

In: European Surgery - Acta Chirurgica Austriaca, Vol. 47, No. 5, 15.10.2015, p. 238-242.

Research output: Contribution to journalArticle

Dulskas, A. ; Samalavicius, N. E. ; Gupta, R. K. ; Zabulis, V. ; Samalavicius, R. S. ; Kutkauskiene, J. ; Escalante, R. / Hand-assisted laparoscopic surgery for left sided colorectal cancer : is quality of surgery related with experience?. In: European Surgery - Acta Chirurgica Austriaca. 2015 ; Vol. 47, No. 5. pp. 238-242.
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abstract = "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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