[Laparoscopic radical cystectomy: analysis of a single-surgeon learning curve of 60 cases].
OBJECTIVE
To evaluate the changes in perioperative outcomes that might refect progress along the learning curving by a single-surgeon's experience in our institution with laparoscopic radical cystectomy (LRC).


METHODS
This report was conducted between May 2004 and January 2012 in 60 patients (9 women and 51 men) who underwent LRC for bladder cancer. The mean patient age was (60.8±11.4) years, and mean BMI was (23.9±2.7) kg/m(2). We divided the patients into 3 groups (group A, group B, and group C; each group had twenty patients) by the time, and compared the operative time, intraoperative blood loss, hospital stay among the three groups.


RESULTS
The mean intraoperative blood loss was (799.2±717.8) mL, the mean operative time was (420.2±119.8) minutes, and the mean hospital stay was (15.7±11.0) d; There was no statistically significant difference in age, American Society of Anesthesiologists (ASA) scores and BMI among the three groups (P>0.05). Their operative time was (497.5±131.2), (413.6±75.6) and (349.4±100.2) minutes, respectively, for each group, P<0.001. The intraoperative blood loss was (1 080.0±1 028.8), (862.5±510.6) and (455.5±262.3) mL, for each group, P=0.018. The hospital stay was (20.8±13.5), (16.4±10.6) and (9.8±4.4) d, for each group, P=0.005. However, there was no statistically significant difference in postoperative complications among the three groups.


CONCLUSIONS
Our experience of LRC appears to be favorable with reduction in blood loss, operative time and hospital stay with increasing experience. The curving shows a significant decline at 2 different breakpoints: after the first 20 cases, and after 40 cases.
Department of Urology, Peking University First Hospital, Beijing, China.
Wei
W
Zheng
Xin
X
Wu
Lei
L
Zhang
Gang
G
Song
Zheng
Z
Zhang
Kan
K
Gong
Yi
Y
Song
Xue-song
XS
Li
Zhi-song
ZS
He
Li-qun
LQ
Zhou
D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002983:Clinical Competence; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D059032:Learning Curve; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000601:surgery*