Exploration on the learning curve of robotic-assisted kidney transplantation
10.3969/j.issn.1674-7445.2024110
- VernacularTitle:机器人辅助肾移植术学习曲线探讨
- Author:
Shuncheng TAN
1
;
Jianchun CUI
;
Xun SUN
;
Wei HU
;
Yunchong ZHOU
;
Yonglin SONG
;
Shuxin LI
;
Yinrui MA
;
Yafei ZHANG
Author Information
1. 650011 昆明,昆明市第一人民医院泌尿外科
- Keywords:
Robot;
Kidney transplantation;
Learning curve;
Cumulative sum;
Vascular anastomosis;
Ureteral anastomosis;
Serum creatinine;
Complication
- From:
Organ Transplantation
2024;15(6):928-934
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the learning curve of robotic-assisted kidney transplantation(RAKT).Methods The clinical data of 96 consecutive RAKT patients performed by the same surgical team were retrospectively analyzed.The arterial anastomosis time,venous anastomosis time,ureteral anastomosis time,hospital stay,and blood loss were selected as evaluation indicators.The learning curve of RAKT was analyzed using the cumulative sum(CUSUM),and the curve was divided into the learning improvement stage and the proficient mastery stage according to the learning curve.The learning curve was verified by comparing the general data and surgical data of patients in different learning stages,and the clinical efficacy of each stage was analyzed.Results The optimal fitting equation of the learning curve reached its peak at the 33rd case,which was the minimum number of surgeries required to master RAKT.There was no statistically significant difference in age,gender,dialysis type,previous abdominal surgery history,number of donor renal arteries,and preoperative serum creatinine between the learning improvement group and the proficient mastery group(all P>0.05).Compared with the learning improvement stage,the body mass index(BMI)was higher,and the number of right donor kidney was increased compared to the left donor kidney in the proficient mastery stage(both P<0.05).There were no significant differences in arterial anastomosis time,ureteral anastomosis time,postoperative serum creatinine,and complications between the two groups(all P>0.05).The iliac vessel dissection time,warm ischemia time,venous anastomosis time,blood loss,and hospital stay in the proficient mastery stage were superior to those in the learning improvement stage,with statistically significant differences(all P<0.05).Conclusions RAKT requires at least 33 cases to cross the learning curve.There is no difference in complications and recovery of transplant renal function between the learning improvement stage and the proficient mastery stage.
