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Analysis of the Learning Curve Effect on the Quality of the Surgical Procedure in 300 Laparoscopic Colorectal Surgeries

N. Belev, P. Rusev, N. Shopov, K. Staneva


Introduction: We compared the quality of the surgical procedure during our training in laparoscopic coloproctology. Materials and Methods: The study included 300 laparoscopic colorectal surgeries due to colorectal cancer in the period March 1, 2009 - May 31, 2013. They were performed at UMHAT – Evrohospital, Plovdiv. The patients were divided into three groups according to the number of interventions performed. The first group was 1-20 surgeries, the second one 20-40 and the third one - more than 40 procedures. Results: We observed a significant reduction in the operating time in laparoscopic right hemicolectomy (185 min. vs 100 min.). Anterior resection operating time for upper rectal cancer was reduced to 120 min, rather than 210 min. We did not find a significant reduction in the duration of surgery for distal rectal surgeries. Patients with convertion decreased from 11% in the first group to 4% in the third, as these were mostly patients with distal rectal cancer. The frequency of insufficiency was 6% in the first group, with no significant difference in perspective.Conclusion: With the ascent of the training curve the operating time was reduced as well as the percentage of convertion rate. The nature of the complications changed. The major surgical complications did not change with training. There is probably an extension of the indications for laparoscopic surgery with the accumulation of relevant experience.


Keywords: colorectal surgery, laparoscopic surgery, learning curve



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About The Authors

N. Belev

P. Rusev

N. Shopov

K. Staneva

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