Definition of learning curve for thyroidectomy: systematic review on the different approaches.
Thyroid surgery
endoscopic thyroidectomy
learning curve (LC)
robotic thyroidectomy
thyroidectomy
Journal
Gland surgery
ISSN: 2227-684X
Titre abrégé: Gland Surg
Pays: China (Republic : 1949- )
ID NLM: 101606638
Informations de publication
Date de publication:
31 Jul 2023
31 Jul 2023
Historique:
received:
16
12
2022
accepted:
29
05
2023
medline:
20
9
2023
pubmed:
20
9
2023
entrez:
20
9
2023
Statut:
ppublish
Résumé
Thyroidectomy is one of the most common surgical procedures carried out worldwide and it has evolved in recent years with alternative approaches. With the advent of minimally invasive techniques, the learning curve (LC) concept has become a fundamental "dogma". A literature search, according to the PRISMA guidelines, was performed via PubMed (MEDLINE), Scopus, Cochrane Library, EMBASE, and Web of Science. Only studies assessing the learning process to thyroidectomy (including hemi- and total thyroidectomy), reporting a minimum of 30 procedures and describing clearly the minimum number of performances required to achieve proficiency and the main evaluation items used to establish it, were included. Conventional, endoscopic and robotic approaches were separately analyzed. Only English-language studies were considered. Forty-five relevant studies were selected for the analysis [respectively 16 concerning robotic thyroidectomy (RT), 22 endoscopic thyroidectomy (ET), 6 mini-invasive video assisted thyroidectomy (MIVAT), 1 conventional thyroidectomy (CT)]. The number of procedures required for a single surgeon to achieve competence and the parameters used to define surgical proficiency were fully investigated for each individual technique. Our research shows how the current literature lacks an objective definition of the LC concept. The heterogeneity of analysis methodologies and parameters evaluated, the various surgical techniques and training background of single surgeons, make it impossible to draw univocal results. Future studies should consider confounding factors and establish criteria that should be consensually recognized in the assessment of surgical performances and skills.
Sections du résumé
Background
UNASSIGNED
Thyroidectomy is one of the most common surgical procedures carried out worldwide and it has evolved in recent years with alternative approaches. With the advent of minimally invasive techniques, the learning curve (LC) concept has become a fundamental "dogma".
Methods
UNASSIGNED
A literature search, according to the PRISMA guidelines, was performed via PubMed (MEDLINE), Scopus, Cochrane Library, EMBASE, and Web of Science. Only studies assessing the learning process to thyroidectomy (including hemi- and total thyroidectomy), reporting a minimum of 30 procedures and describing clearly the minimum number of performances required to achieve proficiency and the main evaluation items used to establish it, were included. Conventional, endoscopic and robotic approaches were separately analyzed. Only English-language studies were considered.
Results
UNASSIGNED
Forty-five relevant studies were selected for the analysis [respectively 16 concerning robotic thyroidectomy (RT), 22 endoscopic thyroidectomy (ET), 6 mini-invasive video assisted thyroidectomy (MIVAT), 1 conventional thyroidectomy (CT)]. The number of procedures required for a single surgeon to achieve competence and the parameters used to define surgical proficiency were fully investigated for each individual technique.
Conclusions
UNASSIGNED
Our research shows how the current literature lacks an objective definition of the LC concept. The heterogeneity of analysis methodologies and parameters evaluated, the various surgical techniques and training background of single surgeons, make it impossible to draw univocal results. Future studies should consider confounding factors and establish criteria that should be consensually recognized in the assessment of surgical performances and skills.
Identifiants
pubmed: 37727342
doi: 10.21037/gs-22-730
pii: gs-12-07-989
pmc: PMC10506114
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
989-1006Informations de copyright
2023 Gland Surgery. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-22-730/coif). The authors have no conflicts of interest to declare.
Références
Front Endocrinol (Lausanne). 2022 Aug 31;13:942973
pubmed: 36120424
World J Surg. 2016 Mar;40(3):491-7
pubmed: 26546193
Head Neck. 2021 Dec;43(12):3946-3954
pubmed: 34632669
N Engl J Med. 1977 May 5;296(18):1044-5
pubmed: 846547
Otolaryngol Head Neck Surg. 2018 Oct;159(4):625-629
pubmed: 30126330
Int J Surg. 2014 Dec;12(12):1273-7
pubmed: 25448644
Updates Surg. 2023 Apr;75(3):691-700
pubmed: 36536189
Onco Targets Ther. 2013;6:47-52
pubmed: 23378774
Eur Surg Res. 2009;43(2):72-6
pubmed: 19478487
Surg Laparosc Endosc Percutan Tech. 2016 Oct;26(5):364-367
pubmed: 27552376
Auris Nasus Larynx. 2021 Jun;48(3):331-338
pubmed: 32636045
Hernia. 2020 Jun;24(3):651-659
pubmed: 31758277
World J Surg. 2011 Apr;35(4):773-8
pubmed: 21267565
BMJ. 2009 Jul 21;339:b2700
pubmed: 19622552
Br J Surg. 2017 Sep;104(10):1405-1411
pubmed: 28718887
Cir Esp (Engl Ed). 2023 Jan;101(1):35-42
pubmed: 35896141
J Laparoendosc Adv Surg Tech A. 2020 Feb;30(2):163-169
pubmed: 31647352
Surg Endosc. 2018 Jan;32(1):456-465
pubmed: 28717869
Gland Surg. 2021 Jun;10(6):1962-1970
pubmed: 34268080
Ann Surg Oncol. 2011 May;18(5):1439-46
pubmed: 21184192
Curr Oncol Rep. 2020 Jun 29;22(8):77
pubmed: 32601931
Surg Innov. 2014 Apr;21(2):221-8
pubmed: 23965590
Int J Surg. 2008;6 Suppl 1:S7-12
pubmed: 19117822
Ann R Coll Surg Engl. 2022 Jun;104(6):414-420
pubmed: 35175830
Arch Surg. 1966 Jun;92(6):861-4
pubmed: 5933254
ScientificWorldJournal. 2012;2012:456807
pubmed: 23304086
Surg Endosc. 2021 Nov;35(11):6179-6189
pubmed: 33111192
Gland Surg. 2015 Oct;4(5):365-7
pubmed: 26425448
Laryngoscope. 2011 Mar;121(3):521-6
pubmed: 21344427
Front Endocrinol (Lausanne). 2021 Oct 21;12:744359
pubmed: 34795638
J Oncol. 2012;2012:734541
pubmed: 23227047
J Nippon Med Sch. 2022 Jun 28;89(3):277-286
pubmed: 34526468
Pol Przegl Chir. 2015 Mar 01;86(12):584-93
pubmed: 25803058
Surg Endosc. 2022 Jan;36(1):117-125
pubmed: 33427912
Int J Surg. 2008;6 Suppl 1:S1-3
pubmed: 19119087
J Clin Med. 2019 Mar 22;8(3):
pubmed: 30909509
Surg Endosc. 2017 Jan;31(1):437-444
pubmed: 27422248
J Clin Med. 2021 Feb 19;10(4):
pubmed: 33669741
Laryngoscope. 2013 Sep;123 Suppl 4:S1-14
pubmed: 23832799
Ann Ital Chir. 2016;87:298-305
pubmed: 27682264
Head Neck. 2015 Dec;37(12):1705-11
pubmed: 24986508
J Minim Access Surg. 2015 Apr-Jun;11(2):119-22
pubmed: 25883451
Surg Laparosc Endosc Percutan Tech. 2015 Oct;25(5):412-6
pubmed: 25730738
Minerva Surg. 2021 Apr;76(2):160-164
pubmed: 32456402
Ann R Coll Surg Engl. 2010 Jul;92(5):379-84
pubmed: 20385050
World J Surg. 2014 Oct;38(10):2632-9
pubmed: 24789015
Surg Endosc. 2019 Apr;33(4):1284-1289
pubmed: 30264276
Surg Endosc. 2009 Aug;23(8):1802-6
pubmed: 19247710
Surg Endosc. 2023 Jan;37(1):535-543
pubmed: 36002679
Surg Endosc. 2019 Feb;33(2):353-365
pubmed: 30267283
J Surg Oncol. 2015 Feb;111(2):135-40
pubmed: 25262911
Br J Surg. 1996 Jun;83(6):875
pubmed: 8696772
Surg Endosc. 1997 Aug;11(8):877
pubmed: 9266657
Surg Laparosc Endosc Percutan Tech. 2000 Feb;10(1):1-4
pubmed: 10872517
Surg Today. 2020 Oct;50(10):1126-1137
pubmed: 31728730
Surg Endosc. 2009 Nov;23(11):2399-406
pubmed: 19263137
Ann Surg. 1977 May;185(5):493-504
pubmed: 324411
Updates Surg. 2022 Jun;74(3):917-925
pubmed: 35489003
J Invest Surg. 2019 Dec;32(8):738-745
pubmed: 29902096
Langenbecks Arch Surg. 2017 Jun;402(4):701-708
pubmed: 27178203
BMJ. 2011 Oct 18;343:d5928
pubmed: 22008217
J Am Coll Surg. 2009 Aug;209(2):e1-7
pubmed: 19632588
Lancet. 1974 Jan 26;1(7848):120-1
pubmed: 4130314
J Craniofac Surg. 2022 Nov-Dec 01;33(8):e802-e806
pubmed: 35767477
Eur Surg Res. 2008;41(1):33-6
pubmed: 18434737
J Am Coll Surg. 2000 Sep;191(3):336-40
pubmed: 10989910
Gland Surg. 2023 Jan 1;12(1):30-38
pubmed: 36761485
Langenbecks Arch Surg. 2000 Jul;385(4):261-4
pubmed: 10958509
World J Surg. 2021 May;45(5):1446-1456
pubmed: 33512565
Clin Exp Otorhinolaryngol. 2019 Feb;12(1):1-11
pubmed: 30196688
Curr Urol Rep. 2006 Mar;7(2):125-9
pubmed: 16526997
Oral Oncol. 2020 Nov;110:104871
pubmed: 32619928
Am Surg. 2021 Apr;87(4):638-644
pubmed: 33142070
Surg Laparosc Endosc Percutan Tech. 2018 Dec;28(6):380-384
pubmed: 30222694
Ann Surg Oncol. 2011 Jan;18(1):226-32
pubmed: 20680695
Postgrad Med J. 2007 Dec;83(986):777-9
pubmed: 18057179
Surg Endosc. 2022 Jul;36(7):4839-4844
pubmed: 34748089
Ann R Coll Surg Engl. 2022 Sep;104(8):618-623
pubmed: 35133210
J Am Coll Surg. 2012 Apr;214(4):558-64; discussion 564-6
pubmed: 22360981
Asian J Surg. 2020 Mar;43(3):482-487
pubmed: 31402083
Head Neck. 2013 Aug;35(8):1078-82
pubmed: 22791472