Learning curve of complete mesocolic excision for colon cancer

Objective To evaluate the learning curve of complete mesocolic excision(CME) for colon cancer.Methods Clinical data of 75 cases in whom CME was performed by a group of surgeons in the Department of Gastrointestinal Surgery,Peking University People's Hospital from November 2009 to June 2011 were reviewed.The patients were divided into three groups (groups A,B,C,25 cases in each group) by operative chronologic sequence.Results There were no significant differences in age,sex,preoperative staging,cancer location,operation history of abdomen,ASA among the three groups (P＞0.05).The operative time in group A was (205.4±53.2) min and decreased to (180.4±29.7) min in group B and (169.8±41.3) min in group C (P＜0.05).The postoperative hospital stay decreased from (17.8±10.9) d in group A to (12.9±4.1) d in group B and (11.0±3.5) d in group C (P＜0.05).The postoperative complication rate decreased from 32％(8/25) in group A and 36％(9/25) to 8％(2/25)in group C.The specimen quality was superior in group C compared to group A (WEST grade C above were 20 and 11 respectively,P＜0.05).There were no significant differences in intraoperative bleeding,time to first flatus,postoperative fasting time,number of retrieved lymph nodes among the three groups (P＞0.05).Conclusion From the learning curve of CME, surgeons can learn CME skill after performing 25 cases. Key words: Colonic neoplasms;  Complete mesocolic excision;  Learning curve