title: Seniors have a better learning curve for laparoscopic colorectal cancer resection.
abstract: OBJECTIVE
  This study was designed to evaluate the outcomes of laparoscopic colorectal resection in a period of learning curve completed by surgeons with different experience and aptitudes with a view to making clear whether seniors had a better learning curve compared with juniors.
  
  
  METHODS
  From May 2010 to August 2012, the first twenty patients underwent laparoscopic colorectal resection completed by each surgeon were selected for analysis retrospectively. A total of 240 patients treated by 5 seniors and 7 juniors were divided into the senior group (n=100) and the junior group (n=140). The short-term outcomes of laparoscopic surgery of the two groups were compared.
  
  
  RESULTS
  The mean numbers of lymph nodes harvested were 21.2 ± 11.0 in the senior group and 17.3 ± 11.5 in the junior group (p=0.010); The mean operative times were 187.9 ± 60.0 min as compared to 231.3 ± 55.7 min (p=0.006), and blood loss values were 177.0 ± 100.7 ml and 234.0 ± 185 ml, respectively (p=0.001); Conversion rate in the senior group was obviously lower than in the junior group (10.0% vs 20.7%, p=0.027) and the mean time to passing of first flatus were 3.3 ± 0.9 and 3.8 ± 0.9 days (p=0.001). For low rectal cancer, the sphincter preserving rates were 68.7% and 35.3% (p=0.027).
  
  
  CONCLUSIONS
  Seniors could perform laparoscopic colorectal resection with relatively better oncological outcomes and quicker recovery, and seniors could master the laparoscopic skill more easily and quickly. Seniors had a better learning curve for laparoscopic colorectal cancer resection compared to juniors.
authors.affiliation: Department of Gastrointestinal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China E-mail : zhouzx_01@163.com.
authors.forename: Xing-Mao
authors.initials: XM
authors.lastname: Zhang
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Liang
authors.forename: Zhi-Xiang
authors.initials: ZX
authors.lastname: Zhou
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D059032:Learning Curve; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D066231:Surgeons