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Revista do Colégio Brasileiro de Cirurgiões

Print version ISSN 0100-6991On-line version ISSN 1809-4546

Abstract

KONDO, William et al. Learning curve in the laparoscopic fundoplication during the general surgery residency program. Rev. Col. Bras. Cir. [online]. 2006, vol.33, n.2, pp.96-100. ISSN 0100-6991.  http://dx.doi.org/10.1590/S0100-69912006000200008.

BACKGROUND: The laparoscopic treatment for gastroesophageal reflux disease by total fundoplication is the current surgical treatment of choice after failure of appropriate medical treatment. This article shows the learning curve in the Surgical Residency Program. METHODS: We analysed 60 charts of patients submitted to laparoscopic fundoplication between March and October 2005. Patients were separated in 2 groups, and the first 30 cases were compared to the following 30 cases. We collected the following data: operative time, conversion rate, complications ant length of hospitalization. RESULTS: Laparoscopic fundoplication was performed in 18 men and 42 women, with mean age of 48.3 years. Comparing both groups, there was a significant difference in the total operative time (92.7 vs 76.7 minutes, p=0,003), in the Nissen-Rossetti procedure duration (86.7 vs. 68.4 minutes, p=0,00006) and in the ligation of short gastric vessels time (22 vs. 13.1 minutes, p=0,00005). The number of intraoperative complications was bigger in the first group, but the difference was not statistically significant (p=0,2). No conversion was observed in our series. There was no death. Patients were discharged from the hospital in average at the first postoperative day in both groups (p=0,06). CONCLUSION: Laparoscopic fundoplication can be safely performed by residents in their Residency Program with low morbidity rate. We could demonstrate that the effect of the learning curve was more representative related to the operation time.

Keywords : Gastroesophageal reflux; Digestive system surgical procedures [methods]; Fundoplication; Laparoscopy; Learning; Internship and residency; Specialties, surgical [education].

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