PURPOSE: To compare the learning curves for mastering OP and LP surgical techniques, in terms of effects on completion times and postoperative outcomes/complications. METHODS: A retrospective analysis was performed for 198 patients with hypertrophic pyloric stenosis. The learning curves were in regard to two groups of surgeons: three of whom performed 106 OPs while three others performed 92 LPs. Treatment-related complications were divided into two categories: specific complications relating to the pyloromyotomy and non-specific complications. A logistic regression model with repeated data was used to explore the occurrence of complications. RESULTS: The overall postoperative complication rates were not significantly different between the OP (15.1 %) and the LP (11.8 %) groups. Specific complications were more frequent in the LP group (6.4 versus 2.8 %), while non-specific complications were more frequent in the OP group (12.1 versus 5.3 %). The occurrence of complications exhibited a statistically decreasing risk with each supplementary procedure that was performed (p = 0.0067) in the LP group, but not in the OP group (p = 0.9665). CONCLUSION: From a learning process perspective, laparoscopy is mainly associated with a significantly higher risk of specific complications. This risk decreases in line with the surgeon's level of experience, whereas non-specific complications remain stable in open procedures.
PURPOSE: To compare the learning curves for mastering OP and LP surgical techniques, in terms of effects on completion times and postoperative outcomes/complications. METHODS: A retrospective analysis was performed for 198 patients with hypertrophic pyloric stenosis. The learning curves were in regard to two groups of surgeons: three of whom performed 106 OPs while three others performed 92 LPs. Treatment-related complications were divided into two categories: specific complications relating to the pyloromyotomy and non-specific complications. A logistic regression model with repeated data was used to explore the occurrence of complications. RESULTS: The overall postoperative complication rates were not significantly different between the OP (15.1 %) and the LP (11.8 %) groups. Specific complications were more frequent in the LP group (6.4 versus 2.8 %), while non-specific complications were more frequent in the OP group (12.1 versus 5.3 %). The occurrence of complications exhibited a statistically decreasing risk with each supplementary procedure that was performed (p = 0.0067) in the LP group, but not in the OP group (p = 0.9665). CONCLUSION: From a learning process perspective, laparoscopy is mainly associated with a significantly higher risk of specific complications. This risk decreases in line with the surgeon's level of experience, whereas non-specific complications remain stable in open procedures.
Authors: Nigel J Hall; Simon Eaton; Aaron Seims; Charles M Leys; John C Densmore; Casey M Calkins; Daniel J Ostlie; Shawn D St Peter; Richard G Azizkhan; Daniel von Allmen; Jacob C Langer; Eveline Lapidus-Krol; Sarah Bouchard; Nelson Piché; Steven Bruch; Robert Drongowski; Gordon A MacKinlay; Claire Clark; Agostino Pierro Journal: J Pediatr Surg Date: 2013-10-23 Impact factor: 2.545
Authors: Shawn D St Peter; George W Holcomb; Casey M Calkins; J Patrick Murphy; Walter S Andrews; Ronald J Sharp; Charles L Snyder; Daniel J Ostlie Journal: Ann Surg Date: 2006-09 Impact factor: 12.969
Authors: Nigel J Hall; Maurizio Pacilli; Simon Eaton; Kim Reblock; Barbara A Gaines; Aimee Pastor; Jacob C Langer; Antti I Koivusalo; Mikko P Pakarinen; Lutz Stroedter; Stefan Beyerlein; Munther Haddad; Simon Clarke; Henri Ford; Agostino Pierro Journal: Lancet Date: 2009-01-18 Impact factor: 79.321
Authors: Aurélien Binet; C Klipfel; P Meignan; F Bastard; A R Cook; K Braïk; A Le Touze; T Villemagne; M Robert; Q Ballouhey; F Lengelle; S Amar; H Lardy Journal: Pediatr Surg Int Date: 2018-02-06 Impact factor: 1.827