Learning Curve Of Laparoscopy-assisted Radical Gastrectomy For Gastric Cancer

Objective To investigate the learning curve of laparoscopy-assisted radical gastrectomy (LARG) for gastric cancer.Methods Retrospective analysis from January 2007 to November 2008 our department carried out laparoscopy-assisted radical gastrectomy in patients with early clinical data of 150 cases.The patients were divided into three groups(group A, B and C; 50 cases in each group) by operative sequence.The operating time,blood loss,conversion rate to open surgery,the number of lymph nodes resected ,postoperative aerofluxus time,hospital stay, postoperative complications rate were compared among the 3 groups.Results No significant difference existed in clinical data among the 3 groups.The operating time in group B(258.8±65.9min),C(240.6±46.5min)decreased significantly than that in group A(318.0±42.4min)(P< 0.05);there was no significant difference between group B and C (P> 0.05).The blood loss in group B(61.2±67.8ml),C(59.3±100.3ml)decreased significantly than that in group A(99.0±77.0ml)(P<0.05);there was no significant difference between group B and C (P>0.05).Conversion rate to open surgery was 18.0%(9 cases) in group A, 4.0%(2 cases) in group B and 2.0%(1 case) in group C, it showed significant variation among the 3 groups(P<0.05). The number of the lymph nodes resected increased significantly in group B and C than that in group A (P<0.05), there was no significant difference between group B and C (P>0.05).The arofluxus time in group B(3.4±0.8d),C组(3.6±0.8d)decreased significantly than that in group A(4.7±1.3d)(P<0.05);there was no significant difference between group B and C (P> 0.05).The hospital stay in group B (13.7±4.4d),C组(12.5±5.6d)decreased significantly than that in group A(15.6±7.0d)(P< 0.05); there was no significant difference between group B and C (P>0.05).The postoperative complications rate were 12.0%(6/50)in group A,10.0%(5/50) in group B, 12.0%(6/50) in group C; it showed no significant variation among the 3 groups(P>0.05).Conclusion The learning curve of LARG for gastric cancer consisted of approximate 50 cases,then surgical skill can acquire proficiency.