Uniportal video-assisted anatomical segmentectomy: an analysis of the learning curve.
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
29 Jul 2023
29 Jul 2023
Historique:
received:
12
01
2023
accepted:
28
06
2023
medline:
31
7
2023
pubmed:
30
7
2023
entrez:
29
7
2023
Statut:
epublish
Résumé
This study aimed to demonstrate the learning curve of anatomical segmentectomy performed by uniportal video-assisted thoracoscopic surgery (U-VATS). We conducted a retrospective study of U-VATS segmentectomies performed by the same surgeon between September 2019 and August 2022. The learning curve was demonstrated using risk-adjusted cumulative sum (RA-CUSUM) analysis in terms of perioperative complications, which reflected surgical quality and technique proficiency. The surgical outcomes were also compared between different phases. The complication-based learning curve of U-VATS segmentectomy could be divided into two phases based on RA-CUSUM analysis: phase I, the initial learning phase (cases 1-50) and phase II, the proficiency phase (cases 51-141). Significantly higher complication rates (24.0 vs. 8.8%, p=0.013), longer surgical times (119.8±31.9 vs. 106.2±23.8 min, p=0.005), and more blood loss (20 [IQR, 20-30] vs. 20 [IQR, 10-20] ml, p=0.003) were observed in phase I than in phase II. The learning curve of U-VATS segmentectomy consists of two phases, and at least 50 cases were required to gain technique proficiency and achieve high-quality surgical outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
This study aimed to demonstrate the learning curve of anatomical segmentectomy performed by uniportal video-assisted thoracoscopic surgery (U-VATS).
METHOD
METHODS
We conducted a retrospective study of U-VATS segmentectomies performed by the same surgeon between September 2019 and August 2022. The learning curve was demonstrated using risk-adjusted cumulative sum (RA-CUSUM) analysis in terms of perioperative complications, which reflected surgical quality and technique proficiency. The surgical outcomes were also compared between different phases.
RESULT
RESULTS
The complication-based learning curve of U-VATS segmentectomy could be divided into two phases based on RA-CUSUM analysis: phase I, the initial learning phase (cases 1-50) and phase II, the proficiency phase (cases 51-141). Significantly higher complication rates (24.0 vs. 8.8%, p=0.013), longer surgical times (119.8±31.9 vs. 106.2±23.8 min, p=0.005), and more blood loss (20 [IQR, 20-30] vs. 20 [IQR, 10-20] ml, p=0.003) were observed in phase I than in phase II.
CONCLUSION
CONCLUSIONS
The learning curve of U-VATS segmentectomy consists of two phases, and at least 50 cases were required to gain technique proficiency and achieve high-quality surgical outcomes.
Identifiants
pubmed: 37516847
doi: 10.1186/s12957-023-03086-7
pii: 10.1186/s12957-023-03086-7
pmc: PMC10386600
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
232Subventions
Organisme : Elite Medical Professionals Project of China-Japan Friendship Hospital
ID : ZRJY2021-QM23
Organisme : National Key R&D Program of China
ID : 2022YFC2407302
Organisme : National High Level Hospital Clinical Research Funding
ID : 2022-NHLHCRF-YS-04
Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2023. The Author(s).
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