Surgical efficacy and learning curves of laparoscopic complete mesocolic excision with intracorporeal anastomosis for right‐sided colon cancer: A retrospective two‐center cohort study

Abstract

AbstractBackgroundThere is a potential benefit on long‐term outcomes following complete mesocolic excision (CME) for right‐sided colon cancer when compared to conventional colectomy. This study aims to analyze the learning curve and short‐term outcomes of laparoscopic CME with intracorporeal anastomosis (ICA) for right‐sided colon cancer in the hands of experienced colorectal surgeons.MethodsA two‐center cohort study of consecutive patients undergoing right‐sided colectomy from September 2021 to May 2022 at two tertiary colorectal centers in Denmark. Learning curves of surgical time were estimated using a cumulative sum analysis (CUSUM).ResultsA total of 61 patients were included. According to the CUSUM analysis, 32 cases were needed to obtain a peak in operative time, resulting in a decrease in time consumption (group 1/learning phase: 217.2 min [SD 53.6] and group 2/plateau phase 191.6 min [SD 45.1], p = 0.05). There was a nonsignificant reduction in the rates of severe surgical complications (Clavien–Dindo > 3) (13% vs. 7%, p = 0.67) between the two groups, while the length of hospital stay remained constant (median 3.0 days, interquartile range, IQR [2.0; 4.0]).ConclusionThe learning curve of laparoscopic CME with ICA for right‐sided colon cancer demonstrated that 32 cases were needed to obtain a plateau phase expressed by operative time.