Preliminary results of laparoscopic colorectal resections: does surgeon's age influences outcomes?
BACKGROUND
Several randomized controlled trials demonstrated that laparoscopic colon resection is a safe and effective technique for colon and rectum diseases. In fact mini-invasive procedure required an adequate learning curve to safely perform it. Many studies confirm there is a comparatively long learning curve in laparoscopic surgery, with demonstrable decrease in conversion and complication rates with increasing experience.


OBJECTIVE
In this study we want to demonstrate feasibility of laparoscopic colon resection performed by a junior surgeon, referring to short-term outcomes as primary end point.


RESULTS
A total of 163 patients underwent colorectal resections of whom 88 were enrolled in the laparoscopic (LCR) and 75 in the open group, respectively. The mean operative time was 183.4 min in the LCR group and 151.2 min in the open group. The mean number of lymph nodes collected was 21.3 in the LCR group and 22.1 in the open group. 10.5% who underwent LCR developed postoperative complications compared with 16% of open group; this difference was statistically significant. Postoperative death occurred in one patient for each group.


CONCLUSIONS
Our study demonstrate that results obtained by an under 35-year-old surgeon, fully trained in laparoscopic surgery but with limited overall experience in colorectal resections, can be at least as good as the ones obtained in open surgery. This seems to be true both in term of intra-postoperative complications as well as for oncological results.
Boni
L
L
Department of Surgical Sciences, Minimally Invasive Surgery Research Center, University of Insubria-Varese, Viale Borri 57, Varese 21100, Italy. luigi.boni@uninsubria.it
Di Giuseppe
M
M
Bertoglio
C
C
Benevento
A
A
Dionigi
G
G
Rovera
F
F
Dionigi
R
R
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D003082:Colectomy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery*; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function; D012086:Reoperation