Learning curve and safety of the implementation of laparoscopic complete mesocolic excision with intracorporeal anastomosis for right-sided colon cancer: results from a propensity score-matched study

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dc.contributor.authorVela, Javier
dc.contributor.authorRiquoir, Christophe
dc.contributor.authorJarry, Cristian
dc.contributor.authorSilva, Felipe
dc.contributor.authorBesser, Nicolas
dc.contributor.authorUrrejola, Gonzalo
dc.contributor.authorMolina, Maria Elena
dc.contributor.authorMiguieles, Rodrigo
dc.contributor.authorBellolio, Felipe
dc.contributor.authorLarach, Jose Tomas
dc.date.accessioned2025-01-20T16:12:46Z
dc.date.available2025-01-20T16:12:46Z
dc.date.issued2024
dc.description.abstractBackgroundRetrospective studies and randomized controlled trials support the safety of laparoscopic complete mesocolic excision (CME) for the treatment of right-sided colon cancer (RSCC). Few studies, however, examine the learning curve of this operation and its impact on safety during an implementation period. We aim to evaluate the learning curve and safety of the implementation of laparoscopic CME with intracorporeal anastomosis for RSCC.MethodsConsecutive patients undergoing a laparoscopic right colectomy with intracorporeal anastomosis for RSCC between January 2016 and June 2023 were included. Clinical, perioperative, and histopathological variables were collected. Correlation and cumulative sum (CUSUM) analyses between the operating time and case number were performed. Breakpoints of the learning curve were estimated using the broken-line model. CME and conventional laparoscopic right colectomy outcomes were compared after propensity score matching (PSM).ResultsTwo hundred and ninety patients underwent laparoscopic right colectomy during study period. One hundred and eight met inclusion criteria. After PSM, 56 non-CME and 28 CME patients were compared. CME group had a non-statistically significant tendency to a longer operating time (201 versus 195 min; p = 0.657) and a shorter hospital stay (3 versus 4 days; p = 0.279). No significant differences were found in total complication rates or their profile. Correlation analysis identified a significant trend toward operating time reduction with increasing case numbers (Pearson correlation coefficient = - 0.624; p = 0.001). According to the CUSUM analysis, an institutional learning curve was deemed completed after 13 cases and the broken-line model identified three phases: learning (1-6 cases), consolidation (7-13 cases), and mastery (after 13 cases).ConclusionThe learning curve of laparoscopic CME for RSCC can be achieved after 13 cases in centers with experience in advanced laparoscopic surgery and surgeons with familiarity with this technique. Its implementation within this setting seems to be as safe as performing a conventional right colectomy.
dc.fuente.origenWOS
dc.identifier.doi10.1007/s00464-024-11086-1
dc.identifier.eissn1432-2218
dc.identifier.issn0930-2794
dc.identifier.urihttps://doi.org/10.1007/s00464-024-11086-1
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/90353
dc.identifier.wosidWOS:001272926300002
dc.issue.numero9
dc.language.isoen
dc.pagina.final5121
dc.pagina.inicio5114
dc.revistaSurgical endoscopy and other interventional techniques
dc.rightsacceso restringido
dc.subjectLaparoscopic colectomy
dc.subjectComplete mesocolic excision
dc.subjectRight hemicolectomy
dc.subjectColon cancer
dc.subjectLearning curve
dc.subjectImplementation
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleLearning curve and safety of the implementation of laparoscopic complete mesocolic excision with intracorporeal anastomosis for right-sided colon cancer: results from a propensity score-matched study
dc.typeartículo
dc.volumen38
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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