Journal of Gastric Cancer

  • 제15권1호
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  • Pages.29-38
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  • 2015
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Lessons Learned from a Comparative Analysis of Surgical Outcomes of and Learning Curves for Laparoscopy-Assisted Distal Gastrectomy

  • Moon, Jun-Seok (Department of Surgery, Korea University College of Medicine) ;
  • Park, Man Sik (Department of Statistics, College of Natural Sciences, Sungshin Women's University) ;
  • Kim, Jong-Han (Department of Surgery, Korea University College of Medicine) ;
  • Jang, You-Jin (Department of Surgery, Korea University College of Medicine) ;
  • Park, Sung-Soo (Department of Surgery, Korea University College of Medicine) ;
  • Mok, Young-Jae (Department of Surgery, Korea University College of Medicine) ;
  • Kim, Seung-Joo (Department of Surgery, Korea University College of Medicine) ;
  • Kim, Chong-Suk (Department of Surgery, Korea University College of Medicine) ;
  • Park, Seong-Heum (Department of Surgery, Korea University College of Medicine)
  • 투고 : 2014.10.08
  • 심사 : 2015.02.04
  • 발행 : 2015.03.30
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초록

Purpose: Before expanding our indications for laparoscopic gastrectomy to advanced gastric cancer and adopting reduced port laparoscopic gastrectomy, we analyzed and audited the outcomes of laparoscopy-assisted distal gastrectomy (LADG) for adenocarcinoma; this was done during the adoptive period at our institution through the comparative analysis of short-term surgical outcomes and learning curves (LCs) of two surgeons with different careers. Materials and Methods: A detailed comparative analysis of the LCs and surgical outcomes was done for the respective first 95 and 111 LADGs performed by two surgeons between July, 2006 and June, 2011. The LCs were fitted by using the non-linear ordinary least squares estimation method. Results: The postoperative morbidity and mortality rates were 14.6% and 0.0%, respectively, and there was no significant difference in the morbidity rates (12.6% vs. 16.2%, P=0.467). More than 25 lymph nodes were retrieved by each surgeon during LADG procedures. The LCs of both surgeons were distinct. In this study, a stable plateau of the LC was not achieved by both surgeons even after performing 90 LADGs. Conclusions: Regardless of the experience with gastrectomy or laparoscopic surgery for other organs, or the age of surgeon, the outcome was quite acceptable; the learning process differ according to the surgeon's experience and individual characteristics.

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참고문헌

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  3. Laparoscopic Gastrectomy Performed by an Expert in Open Gastrectomy vol.17, pp.3, 2015, https://doi.org/10.5230/jgc.2017.17.e30
  4. Safety of laparoscopic distal gastrectomy for gastric cancer when performed by trainee surgeons with little experience in performing open gastrectomy vol.48, pp.2, 2015, https://doi.org/10.1007/s00595-017-1569-8
  5. Long-term oncologic outcomes of robotic gastrectomy for gastric cancer compared with laparoscopic gastrectomy vol.21, pp.2, 2018, https://doi.org/10.1007/s10120-017-0740-7
  6. Learning curve and short-term outcomes of modularized LADG for advanced gastric cancer : A retrospective study vol.98, pp.10, 2019, https://doi.org/10.1097/md.0000000000014670
  7. Effectiveness and safety of robotic versus traditional laparoscopic gastrectomy for gastric cancer: An updated systematic review and meta-analysis vol.15, pp.7, 2015, https://doi.org/10.4103/jcrt.jcrt_798_18
  8. Laparoscopic D2 gastrectomy in advanced gastric cancer: Postoperative outcomes and long‐term survival analysis vol.14, pp.4, 2015, https://doi.org/10.1111/ases.12926