RT Journal Article
SR Electronic
T1 Learning Curve of Intracorporeal Anastomosis in Laparoscopic Colectomy for Right Side Colon Cancer: A Cumulative Sum Analysis
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 3341
OP 3348
DO 10.21873/anticanres.16510
VO 43
IS 7
A1 ISHIZAKI, TETSUO
A1 MAZAKI, JUNICHI
A1 KASAHARA, KENTA
A1 UDO, RYUTARO
A1 TAGO, TOMOYA
A1 NAGAKAWA, YUICHI
YR 2023
UL http://ar.iiarjournals.org/content/43/7/3341.abstract
AB Background/Aim: Recently, laparoscopic colectomy with intracorporeal anastomosis for colon cancer gained popularity due to the evolution of the laparoscopic linear stapler device and improved techniques from laparoscopic surgeons. However, there are technical difficulties associated with intracorporeal anastomosis. The aim of the study was to clarify the number of cases that are required for laparoscopic surgeons to master the technique of intracorporeal anastomosis in right side colon cancer. Patients and Methods: In this retrospective single-center study, 51 consecutive patients who underwent intracorporeal overlap anastomosis, between July 2018 and March 2020, by one laparoscopic surgeon were selected. Clinicopathological and perioperative data were obtained from our database. The learning curves of intracorporeal anastomosis time (IAT) were created using the cumulative sum (CUSUM) method. Results: The CUSUM score for IAT increased as the number of operative cases progressed, up to the 20th case (Phase 1), after which it started to decrease (Phase 2). Compared to the initial learning phase (Phase 1), the master phase (Phase 2) had a significantly faster IAT (p<0.001), significantly decreased incidence of organ/space surgical site infection (p=0.009), and significantly decreased postoperative hospital stay (p=0.021). Conclusion: Twenty cases were required for a laparoscopic surgeon to achieve expertise when conducting intracorporeal anastomosis in laparoscopic colectomy for right side colon cancer. It was suggested that proficiency in intracorporeal anastomosis may contribute to a reduction in the incidence of organ/space surgical site infections and postoperative hospital stay.