title: A comparative clinical study of short-term results of laparoscopic surgery for rectal cancer during the learning curve.
abstract: OBJECTIVE
  The aim of this study was to assess the results of laparoscopic surgery for rectal carcinoma (LSRC) during the learning curve throughout the introduction of this technique at our medical center.
  
  
  METHODS
  From January 2003 to April 2004, 40 patients undergoing surgery were assigned to laparoscopic surgery group (LSG) (n=20) or conventional surgery group (CSG) (n=20). Data were prospectively collected to statistically analyze clinical, anatomopathological, and economic variables.
  
  
  RESULTS
  Groups were comparable in age, sex, body mass index, American Society of Anesthesiologists score, surgical technique performed, tumor size and distance, Dukes' stage, and proportion of patients with previous abdominal surgery and radiotherapy. There was no difference in operative time. LSG blood loss was lower (p<.0001). LSG peristalsis and oral intake began earlier (p<.0001). LSG hospital stay was shorter (p<.0001). Intraoperative complications (10% LSG vs 15% CSG) and overall morbidity (35% LSG vs 45% CSG) were no different. LSG did not record any anastomotic leakages. Two patients (10%) were converted to open surgery. Regarding oncologic adequacy of resection, specimen length and number of nodes harvested were no different. LSG distal and radial resection margins were greater (p<.0001; p=.03). LSG operative costs were greater (p<.0001). However, CSG hospitalization costs were higher (p<.001). There was no overall difference (p=0.1).
  
  
  CONCLUSIONS
  LSRC has been a reliable and efficient technique during the learning curve at our hospital.
authors.affiliation: Department of Gastrointestinal Surgery, Hospital Universitario de Canarias (HUC), Ofra, s/n. La Cuesta, 38320 La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain. ivanhuc@hispavista.com
authors.forename: Ivan
authors.initials: I
authors.lastname: Arteaga González
authors.forename: Hermógenes
authors.initials: H
authors.lastname: Díaz Luis
authors.forename: Antonio
authors.initials: A
authors.lastname: Martín Malagón
authors.forename: Eudaldo M
authors.initials: EM
authors.lastname: López-Tomassetti Fernández
authors.forename: Javier
authors.initials: J
authors.lastname: Arranz Duran
authors.forename: Angel
authors.initials: A
authors.lastname: Carrillo Pallares
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000601:surgery*; D003082:Colectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome