Evidence map›Paper›PMID 39585454›Full record

ArticleLangenbeck's archives of surgery2024

Multidimensional assessment of the learning curve of intracorporeal anastomosis during laparoscopic right colectomy.

Javier Vela, Christophe Riquoir, Felipe Silva, Cristián Jarry, Gonzalo Urrejola, María Elena Molina, Rodrigo Miguieles, Felipe Bellolio, José Tomás Larach

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In one paragraph

Article in Langenbeck's archives of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Javier VelaColorectal Surgery Unit, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
Christophe RiquoirColorectal Surgery Unit, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
Felipe SilvaColorectal Surgery Unit, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
Cristián JarryColorectal Surgery Unit, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
Gonzalo UrrejolaColorectal Surgery Unit, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
María Elena MolinaColorectal Surgery Unit, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rodrigo MiguielesColorectal Surgery Unit, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
Felipe BellolioColorectal Surgery Unit, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
José Tomás LarachColorectal Surgery Unit, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile. jtlarach@uc.cl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAfter resection during a laparoscopic right colectomy (LRC), reconstruction can be conducted with an intracorporeal (IA) or extracorporeal anastomosis. Although IA benefits are well documented, its implementation has been slow due to a steep learning curve (LC) mainly associated with intracorporeal suturing. The aim of this study is to assess the LC of IA in LRC.

methodsConsecutive patients undergoing a LRC with IA between January 2016 and June 2023 were included. Clinical, perioperative, and histopathological variables were collected. Correlation and cumulative sum (CUSUM) analyses between the operating time and case number were performed. 'Surgical success' as a composite outcome was also analysed by performing a CUSUM plot. Completion LC case number was determined based on these analyses. Pre-LC and post-LC perioperative outcomes were compared.

resultsTwo-hundred-and-ninety patients underwent a LRC during the study period. Sixty-seven met inclusion criteria. Correlation analysis identified a significant operating time reduction with increasing case numbers (p = 0.034). Total complications during implementation period were 25,3%, with 6% of severe complications. Operative time CUSUM analysis identified a consistent downwards trend after case 36 and surgical success CUSUM analysis after case 37. Two phases were established: pre-LC (case 0-37th) and post-LC (38th-67). Pre-LC and post-LC revealed a significant decrease in operative time (187vs177.8 min;p = 0.016), and length of stay (4vs3 days;p < 0.001). No difference between overall complications, severe complication, or reoperation rates were detected.

conclusionThe LC of laparoscopic IA can be achieved after 37 cases in centres with experience in advanced laparoscopic surgery. Further studies will be required to confirm these results.

Indexed as

Anastomosis, SurgicalColectomyLaparoscopyLearning CurveOperative TimeAdultAgedFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTreatment OutcomeColon cancerImplementationIntracorporeal anastomosesLaparoscopic colectomyLearning curveRight colectomy

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.