Clinical Experiences with Performing Laparoscopic Radical Nephrectomy after a One-year Educational Program.
10.4111/kju.2008.49.9.786
- Author:
Seung Hyun JEON
1
;
Ill Young SEO
;
Jae Sung LIM
;
Ryohei HATTORI
;
Momokazu GOTOH
;
Yoshinari ONO
Author Information
1. Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea. juro@khu.ac.kr
- Publication Type:Original Article
- Keywords:
Nephrectomy;
Laparoscopic
- MeSH:
Carcinoma, Renal Cell;
Intraoperative Complications;
Laparoscopy;
Learning Curve;
Nephrectomy;
Operative Time;
Vascular System Injuries
- From:Korean Journal of Urology
2008;49(9):786-790
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Laparoscopic radical nephrectomy is a standard treatment for localized renal cell carcinoma. Although it is less invasiveness than open surgery, it has a steeper learning curve compared with open surgery. We analyzed the results of laparosopic radical nephrectomy that was performed by 3 surgeons who had finished a 1-year laparoscopy educational program. MATERIALS AND METHODS: A total of 103 cases of laparoscopic radical nephrectomy that were performed from June 2003 to July 2007 were enrolled in this study. These cases were performed via a transperitoneal, pure laparoscopic approach. We analyzed each surgeon's operative time, their operative blood loss and the complication rate, and then we examined a sequential transition after dividing the cases into three groups. RESULTS: The average tumor size was 4.69+/-2.21cm. The tumor stage distribution was T1 in 74 cases, T2 in 14 cases, T3a in 13 cases and T3b in 2 cases. The average operative time and calculated operative blood loss were 211.6+/-73.4 min and 553.6+/-466.9ml, respectively. Intraoperative complications occurred in 13 cases(12.6%). There were 2 cases of open conversion due to vascular injury. Surgeon A did a total of 50 cases during 4 years and his average operative time and estimated blood loss 170.8+/- 61.7 min and 577.4+/-457.5ml, respectively. Surgeon B did a total of 29 cases during 3 years and his results were 259+/-74.8 min and 434.8+/-468.1ml, respectively. Surgeon C did 24 cases during 2 years and his results were 239.1+/-45.5 min and 604.3+/-489.7ml, respectively. Sequential analysis of each surgeon's data after dividing the cases into three groups showed that operative time decreased significantly for surgeons A & B. However, the operative blood loss and complication rates did not significantly differ. CONCLUSIONS: This intensified 1-year educational program was successful enough to allow an inexperienced surgeon to complete laparoscopic radical nephrectomy without supervision.
