[Learning curve of laparoscopic-assisted surgery for rectal cancer].

Objective: To investigate the learning curve of laparoscopic-assisted surgery for rectal cancer by comparing the effects of laparoscopic-assisted rectal surgery at different stages with a literature review.

Methods: A total of 160 surgical cases of laparoscopic-assisted rectal cancer from May 2007 to December 2009 were reviewed. Different standards were used to divided them into 11 stages (group 1:15 cases in each) and 8 stages (group 2:20 cases in each) respectively by operative sequences. The number of revealed lymph nodes, length of distal margin, operating duration, blood loss volume, the incidences of intraoperative and postoperative complications, the rate of conversion into open operation and the length of postoperative hospital stay were analyzed. With the exception of the first stage, all indices in the remainder of 10 stages and 7 stages were analyzed simultaneously.

Results: There was no significant differences among the 11 stages and 8 stages with the respect to the number of revealed lymph nodes, length of distal margin, blood loss volume, the incidences of intraoperative and postoperative complications, the rate of conversion into open operation and the length of postoperative hospital stay. The average operating duration in the first stage of group 1 was 201.0 min and 193.0 min in the first stage of group 2. And the operating duration in the first stage in the two groups was longer significantly than the remainder of stages in each group (P < 0.001).

Conclusion: A surgeon may become experienced in laparoscopic-assisted rectal surgery by operating 16 - 20 patients with rectal cancer.