{"title":"Impact of the learning curve on the outcomes of robotic surgery in obese patients with rectal cancer.","authors":"Shota Izukawa, Masakatsu Numata, Toshiyuki Fukuda, Tatsunosuke Harada, Yosuke Atsumi, Keisuke Kazama, Sho Sawazaki, Shinsuke Suzuki, Teni Godai, Akio Higuchi, Hiroshi Tamagawa, Yusuke Suwa, Jun Watanabe, Tsutomu Sato, Aya Saito","doi":"10.1007/s00595-025-03113-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>One of the challenges in performing surgery on obese patients with rectal cancer is the prolonged operation time. This study investigates whether or not this issue can be overcome through the surgeon's learning curve as they become proficient in robotic surgery.</p><p><strong>Methods: </strong>A retrospective review of 396 consecutive robotic procedures. The cases were divided into a learning phase (LP) group (first 20 cases) and a stabilized phase (SP) group (from case 21 onward). Patients were divided into obese (BMI ≥ 25 kg/m<sup>2</sup>) and non-obese groups using 1:1 propensity score matching. This resulted in 130 and 72 patients in the LP and SP groups, respectively. The primary endpoint of this study was operation time.</p><p><strong>Results: </strong>In the LP group, obese patients had significantly longer operative times (329 min vs. 289 min) and greater blood loss (10 g [0-50] vs. 10 g [0-12]) than non-obese patients. In the SP group, the perioperative outcomes, including operation time, were similar between the two patient groups.</p><p><strong>Conclusion: </strong>This study suggests that during the early phase of the learning curve, operation time may be prolonged in obese patients. However, once the learning curve stabilizes, the issue of prolonged operative time can be overcome.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery Today","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00595-025-03113-y","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: One of the challenges in performing surgery on obese patients with rectal cancer is the prolonged operation time. This study investigates whether or not this issue can be overcome through the surgeon's learning curve as they become proficient in robotic surgery.
Methods: A retrospective review of 396 consecutive robotic procedures. The cases were divided into a learning phase (LP) group (first 20 cases) and a stabilized phase (SP) group (from case 21 onward). Patients were divided into obese (BMI ≥ 25 kg/m2) and non-obese groups using 1:1 propensity score matching. This resulted in 130 and 72 patients in the LP and SP groups, respectively. The primary endpoint of this study was operation time.
Results: In the LP group, obese patients had significantly longer operative times (329 min vs. 289 min) and greater blood loss (10 g [0-50] vs. 10 g [0-12]) than non-obese patients. In the SP group, the perioperative outcomes, including operation time, were similar between the two patient groups.
Conclusion: This study suggests that during the early phase of the learning curve, operation time may be prolonged in obese patients. However, once the learning curve stabilizes, the issue of prolonged operative time can be overcome.
目的:肥胖直肠癌患者手术治疗的难点之一是手术时间的延长。这项研究调查了当外科医生熟练掌握机器人手术时,是否可以通过他们的学习曲线来克服这个问题。方法:对396例连续机器人手术进行回顾性分析。这些病例被分为学习阶段(LP)组(前20例)和稳定阶段(SP)组(第21例起)。采用1:1倾向评分匹配法将患者分为肥胖组(BMI≥25 kg/m2)和非肥胖组。结果LP组和SP组分别有130例和72例患者。本研究的主要终点是手术时间。结果:在LP组中,肥胖患者的手术时间明显长于非肥胖患者(329 min vs. 289 min),出血量明显大于非肥胖患者(10 g [0-50] vs. 10 g[0-12])。SP组两组患者围手术期结局(包括手术时间)相似。结论:本研究提示,在学习曲线的早期,肥胖患者的手术时间可能会延长。然而,一旦学习曲线稳定下来,延长手术时间的问题就可以克服。
期刊介绍:
Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it").
The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.