Learning curve and surgical outcomes for laparoscopic surgery, including pelvic lymphadenectomy, for early stage endometrial cancer

• Published in: Japanese journal of clinical oncology Vol. 49; no. 6; pp. 521 - 524
• Main Authors: Togami, Shinichi, Kawamura, Toshihiko, Fukuda, Mika, Yanazume, Shintaro, Kamio, Masaki, Kobayashi, Hiroaki
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.06.2019
• Subjects: Adult; Aged; Blood Loss, Surgical; Endometrial Neoplasms - surgery; Female; Humans; Hysterectomy - methods; Laparoscopy - methods; Learning Curve; Length of Stay; Lymph Node Excision - methods; Middle Aged; Operative Time; Retrospective Studies; endometrial cancer; surgical outcome; laparoscopic surgery; learning curve
• ISSN: 1465-3621; 1465-3621
• DOI: 10.1093/jjco/hyz027

As a surgeon’s experience increased, operative time and blood loss decreased, whereas the number of lymph nodes removed, and length of hospital stay remained constant. Abstract Background The purpose of this study was to determine the learning curve of laparoscopic surgery for the treatment of early endometrial cancer and report the surgical outcomes. Methods Patients: Data were retrospectively extracted from the medical charts of patients who underwent laparoscopic surgery. Intervention Laparoscopic surgery, including pelvic lymphadenectomy, was performed using the same technique and instruments for all patients. Outcomes The learning curve for the surgical technique, characterized by the operative time, number of lymph nodes removed, and volume of intra-operative blood loss, was analyzed. Results Over the period of observation, 82 patients were enrolled. For analysis, cases were classified into four groups, based on their surgery date. Between-group comparisons identified a significant decrease in operative time and volume of blood loss between Groups 1 and 4 (P < 0.05). However, the number of lymph nodes removed, and the length of hospital stay were not influenced by learning. Conclusion The operative time and the amount of blood loss significantly decreased with an increase in the surgeon’s experience but with no effect of learning on the number of lymph nodes removed and length of hospital stay.