Aim: Despite the suggested potential benefit of complete mesocolic excision (CME) for right-sided colon cancer (RCC) for patient survival, concerns about its safety and feasibility have contributed to delayed acceptance of the procedure, especially when performed by a minimally invasive approach. Thus, the aim of this work was to evaluate the actual learning curve (LC) of laparoscopic CME for experienced colorectal surgeons. Method: Prospectively collected data for consecutive patients undergoing laparoscopic CME for RCC between October 2015 and January 2021 at our institution, operated on by experienced surgeons, were analysed. A multidimensional assessment of the LC was performed through cumulative sum (CUSUM) and risk-adjusted (RA) CUSUM analysis. Results: Two hundred and two patients operated by on by three surgeons were considered. The CUSUM graphs based on operating time showed one peak of the curve between 17 and 27 cases. The CUSUM graphs based on surgical failure showed one peak of the curve between 20 and 24 cases The RA-CUSUM curve also showed one preeminent peak at 24–33 cases. Based on the CUSUM and RA-CUSUM analyses all the surgeons reached proficiency in 24–33 cases. Conclusions: Our study showed that an experienced minimally invasive colorectal surgeon acquires proficiency in laparoscopic CME for RCC after performing 24–33 cases.

Giani, A., Veronesi, V., Bertoglio, C., Mazzola, M., Bernasconi, D., Grimaldi, S., et al. (2022). Multidimensional evaluation of the learning curve for laparoscopic complete mesocolic excision for right colon cancer: a risk-adjusted cumulative summation analysis. COLORECTAL DISEASE, 24(5), 577-586 [10.1111/codi.16075].

Multidimensional evaluation of the learning curve for laparoscopic complete mesocolic excision for right colon cancer: a risk-adjusted cumulative summation analysis

Veronesi V.;Bernasconi D. P.;
2022

Abstract

Aim: Despite the suggested potential benefit of complete mesocolic excision (CME) for right-sided colon cancer (RCC) for patient survival, concerns about its safety and feasibility have contributed to delayed acceptance of the procedure, especially when performed by a minimally invasive approach. Thus, the aim of this work was to evaluate the actual learning curve (LC) of laparoscopic CME for experienced colorectal surgeons. Method: Prospectively collected data for consecutive patients undergoing laparoscopic CME for RCC between October 2015 and January 2021 at our institution, operated on by experienced surgeons, were analysed. A multidimensional assessment of the LC was performed through cumulative sum (CUSUM) and risk-adjusted (RA) CUSUM analysis. Results: Two hundred and two patients operated by on by three surgeons were considered. The CUSUM graphs based on operating time showed one peak of the curve between 17 and 27 cases. The CUSUM graphs based on surgical failure showed one peak of the curve between 20 and 24 cases The RA-CUSUM curve also showed one preeminent peak at 24–33 cases. Based on the CUSUM and RA-CUSUM analyses all the surgeons reached proficiency in 24–33 cases. Conclusions: Our study showed that an experienced minimally invasive colorectal surgeon acquires proficiency in laparoscopic CME for RCC after performing 24–33 cases.
Articolo in rivista - Articolo scientifico
complete mesocolic excision; laparoscopy; learning curve; RA-CUSUM; right colon cancer;
English
2-feb-2022
2022
24
5
577
586
none
Giani, A., Veronesi, V., Bertoglio, C., Mazzola, M., Bernasconi, D., Grimaldi, S., et al. (2022). Multidimensional evaluation of the learning curve for laparoscopic complete mesocolic excision for right colon cancer: a risk-adjusted cumulative summation analysis. COLORECTAL DISEASE, 24(5), 577-586 [10.1111/codi.16075].
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/355188
Citazioni
  • Scopus 14
  • ???jsp.display-item.citation.isi??? 15
Social impact