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

Jpn J Clin Oncol. 2019 Jun 1;49(6):521-524. doi: 10.1093/jjco/hyz027.

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.

Keywords: endometrial cancer; laparoscopic surgery; learning curve; surgical outcome.

MeSH terms

  • 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