Learning curve of totally thoracoscopic pulmonary segmentectomy.
10.1007/s11684-017-0566-z
- Author:
Weibing WU
1
;
Jing XU
1
;
Wei WEN
1
;
Yue YU
1
;
Xinfeng XU
1
;
Quan ZHU
2
;
Liang CHEN
3
Author Information
1. Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
2. Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. chest2006@163.com.
3. Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. clbright0909@njmu.edu.cn.
- Publication Type:Letter
- Keywords:
CUSUM;
learning curve;
segmentectomy;
thoracoscopic
- MeSH:
Aged;
China;
Female;
Humans;
Learning Curve;
Length of Stay;
Lung;
surgery;
Male;
Middle Aged;
Minimally Invasive Surgical Procedures;
education;
methods;
Operative Time;
Pneumonectomy;
education;
methods;
Retrospective Studies;
Thoracoscopy;
education;
methods;
Thoracotomy;
education;
methods;
Treatment Outcome
- From:
Frontiers of Medicine
2018;12(5):586-592
- CountryChina
- Language:English
-
Abstract:
Totally thoracoscopic pulmonary segmentectomy (TTPS) is a feasible and safe technique that requires advanced thoracoscopic skills and knowledge of pulmonary anatomy. However, data describing the learning curve of TTPS have yet to be obtained. In this study, 128 patients who underwent TTPS between September 2010 and December 2013 were retrospectively analyzed to evaluate the learning curve and were divided chronologically into three phases, namely, ascending phase (A), plateau phase (B), and descending phase (C), through cumulative summation (CUSUM) for operative time (OT). Phases A, B, and C comprised 39, 33, and 56 cases, respectively. OT and blood loss decreased significantly from phases A to C (P < 0.01), and the frequency of intraoperative bronchoscopy for target bronchus identification decreased gradually (A, 8/39; B, 4/33; C, 3/56; P = 0.06). No significant differences were observed in demographic factors, conversion, complications, hospital stay, and retrieved lymph nodes among the three phases. Surgical outcomes and techniques improved with experience and volume. CUSUMOT indicated that the learning curve of TTPS should be more than 72 cases.
