복강경 대장 절제술 경험이 없는 술자에 의하여 시행된 대장암 복강경 절제술: 초기 50예와 후기 51예 단기성적 비교 (Initial Experiences with a Laparoscopic Colorectal Resection: a Comparison of Short-term Outcomes for 50 Early Cases and 51 Late Cases)

서지정보

· 발행기관 : 대한대장항문학회
· 수록지 정보 : Annals of Coloproctolgy / 25권 / 4호 / 252 ~ 258페이지
· 저자명 : 선장원, 허정욱, 조상혁, 주재균, 김형록, 김영진

초록

Purpose: The present study aimed to investigate the safety and the feasibility of laparoscopic colorectal surgery performed
by a surgeon during a learning period.
Methods: Between April and December 2008, 101 consecutive patients with colorectal cancers underwent laparoscopic
surgery by one colorectal surgeon who previously had no experience with laparoscopic colorectal surgery. Standard laparoscopy
with a lymphadenectomy using a 5-port technique was performed according to the tumor location. The patients were
divided into two chronological groups: 50 cases early in learning period (early cases) and 51 cases later in the learning period
(late cases).
Results: The operations were 29 right hemicolectomies, 9 left hemicolectomies, 18 anterior resections, 35 low anterior resections,
6 intersphincteric resections, 2 abdominoperineal resections, and 2 Hartmann’s operation. There were 7 conversions
(6.9%). The median operating time was 205 (range, 95-385) min, and the median blood loss was 258 (50-800) mL. The
median times to flatus per anus and to feeding of soft diet were 2 (1-5) and 4 (2-13) days, respectively. The median hospital
stay was 9 (6-27) days. There were 21 postoperative complications, including 7 anastomotic complications (3 leakages, 3
abscesses, and 1 stenosis). The median number of lymph nodes harvested was 20 (4-65). The operating time, blood loss,
and complication rates were significantly decreased in the late group.
Conclusion: Our initial experience with laparoscopic colorectal surgery appears to have acceptable perioperative results
and short-term oncologic outcomes, which improved with the experience of the surgeon.

영어초록

Purpose: The present study aimed to investigate the safety and the feasibility of laparoscopic colorectal surgery performed
by a surgeon during a learning period.
Methods: Between April and December 2008, 101 consecutive patients with colorectal cancers underwent laparoscopic
surgery by one colorectal surgeon who previously had no experience with laparoscopic colorectal surgery. Standard laparoscopy
with a lymphadenectomy using a 5-port technique was performed according to the tumor location. The patients were
divided into two chronological groups: 50 cases early in learning period (early cases) and 51 cases later in the learning period
(late cases).
Results: The operations were 29 right hemicolectomies, 9 left hemicolectomies, 18 anterior resections, 35 low anterior resections,
6 intersphincteric resections, 2 abdominoperineal resections, and 2 Hartmann’s operation. There were 7 conversions
(6.9%). The median operating time was 205 (range, 95-385) min, and the median blood loss was 258 (50-800) mL. The
median times to flatus per anus and to feeding of soft diet were 2 (1-5) and 4 (2-13) days, respectively. The median hospital
stay was 9 (6-27) days. There were 21 postoperative complications, including 7 anastomotic complications (3 leakages, 3
abscesses, and 1 stenosis). The median number of lymph nodes harvested was 20 (4-65). The operating time, blood loss,
and complication rates were significantly decreased in the late group.
Conclusion: Our initial experience with laparoscopic colorectal surgery appears to have acceptable perioperative results
and short-term oncologic outcomes, which improved with the experience of the surgeon.

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