title: Learning curve for hand-assisted laparoscopic D2 radical gastrectomy.
abstract: OBJECTIVE
  To describe the learning curves of hand-assisted laparoscopic D2 radical gastrectomy (HALG) for the treatment of gastric cancer.
  
  
  METHODS
  The HALG surgical procedure consists of three stages: surgery under direct vision via the port for hand assistance, hand-assisted laparoscopic surgery, and gastrointestinal tract reconstruction. According to the order of the date of surgery, patients were divided into 6 groups (A-F) with 20 cases in each group. All surgeries were performed by the same group of surgeons. We performed a comprehensive and in-depth retrospective comparative analysis of the clinical data of all patients, with the clinical data including general patient information and intraoperative and postoperative observation indicators.
  
  
  RESULTS
  There were no differences in the basic information among the patient groups (P > 0.05). The operative time of the hand-assisted surgery stage in group A was 8-10 min longer than the other groups, with the difference being statistically significant (P = 0.01). There were no differences in total operative time between the groups (P = 0.30). Postoperative intestinal function recovery time in group A was longer than that of other groups (P = 0.02). Lengths of hospital stay and surgical quality indicators (such as intraoperative blood loss, numbers of detected lymph nodes, intraoperative side injury, postoperative complications, reoperation rate, and readmission rate 30 d after surgery) were not significantly different among the groups.
  
  
  CONCLUSIONS
  HALG is a surgical procedure that can be easily mastered, with a learning curve closely related to the operative time of the hand-assisted laparoscopic surgery stage.
authors: Jia-Qing Gong, Yong-Kuan Cao, Yong-Hua Wang, Guo-Hu Zhang, Pei-Hong Wang, Guo-De Luo, Center of General Surgery, the People's Liberation Army General Hospital of Chengdu Command, Chengdu 610083, Sichuan Province, China.
authors: Jia-Qing
authors: JQ
authors: Gong
authors: Jia-Qing Gong, Yong-Kuan Cao, Yong-Hua Wang, Guo-Hu Zhang, Pei-Hong Wang, Guo-De Luo, Center of General Surgery, the People's Liberation Army General Hospital of Chengdu Command, Chengdu 610083, Sichuan Province, China.
authors: Yong-Kuan
authors: YK
authors: Cao
authors: Jia-Qing Gong, Yong-Kuan Cao, Yong-Hua Wang, Guo-Hu Zhang, Pei-Hong Wang, Guo-De Luo, Center of General Surgery, the People's Liberation Army General Hospital of Chengdu Command, Chengdu 610083, Sichuan Province, China.
authors: Yong-Hua
authors: YH
authors: Wang
authors: Jia-Qing Gong, Yong-Kuan Cao, Yong-Hua Wang, Guo-Hu Zhang, Pei-Hong Wang, Guo-De Luo, Center of General Surgery, the People's Liberation Army General Hospital of Chengdu Command, Chengdu 610083, Sichuan Province, China.
authors: Guo-Hu
authors: GH
authors: Zhang
authors: Jia-Qing Gong, Yong-Kuan Cao, Yong-Hua Wang, Guo-Hu Zhang, Pei-Hong Wang, Guo-De Luo, Center of General Surgery, the People's Liberation Army General Hospital of Chengdu Command, Chengdu 610083, Sichuan Province, China.
authors: Pei-Hong
authors: PH
authors: Wang
authors: Jia-Qing Gong, Yong-Kuan Cao, Yong-Hua Wang, Guo-Hu Zhang, Pei-Hong Wang, Guo-De Luo, Center of General Surgery, the People's Liberation Army General Hospital of Chengdu Command, Chengdu 610083, Sichuan Province, China.
authors: Guo-De
authors: GD
authors: Luo
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000592:standards; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D058733:Hand-Assisted Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D006801:Humans; D059032:Learning Curve; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Gastric cancer; Hand-assisted laparoscopic D2 radical gastrectomy; Learning curve; Operative time; Surgical quality indicators