The learning curve of video-assisted thoracoscopic sleeve lobectomy in patients with central lung cancer
10.3760/cma.j.issn.1001-4497.2019.07.001
- VernacularTitle:全胸腔镜袖式肺叶切除治疗中央型肺癌的学习曲线
- Author:
Desong YANG
1
;
Wenxiang WANG
;
Yong ZHOU
;
Xu LI
;
Baihua ZHANG
;
Jie WU
;
Zhining WU
;
Jinming TANG
Author Information
1. 湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院胸外二科
- Keywords:
VATS;
Sleeve lobectomy;
Learning curve
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(7):385-389
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the learning curve of video-assisted thoracoscopic sleeve lobectomy in patients with central lung cancer.Methods A total of 86 consecutive patients with resected central lung cancer in the second department of thoracic surgery of Hunan Cancer Hospital between Apirl 2016 and July 2018 were retrospectively enrolled.Video-assisted tho-racoscopic tracheoplasty with sleeve resection and lobectomy were performed in 56 patients, video-assisted thoracoscopic tra-cheoplasty with wedge resection and lobectomy were performed in 20 patients, and 10 patients transit to thoracotomy.Surgical parameter of patients who underwent video-assisted thoracoscopic sleeve lobectomy were investigated to assess the learning curve, including operation duration, bleeding volume, amount of lymph nodes examined(medianstinal and intrapulmonary). Lowess smoothing method was performed to fit curve to evaluate the variation tendency of surgical parameters .Cut-off point, as well as the confidence interval, were identified using piecewise regression analysis.Results Surgical duration tend to be stable (almost 200 min) when the cumulative case amount of video-assisted thoracoscopic sleeve lobectomy reach 40.Surgical bleed-ing tend to be stable( almost 200 ml) when the cumulative case amount of video-assisted thoracoscopic sleeve lobectomy reach 20.There is no significant correlation between the amount of lymph node harvest and surgical volume .Conclusion The cut-off point for video-assisted thoracoscopic sleeve lobectomy is approximately 40 cases.
