Video-Assisted Thoracic Surgical Lobectomy for Lung Cancer: Description of a Learning Curve

Yao, Fei; Wang, Jian; Yao, Jun; Hang, Fangrong; Cao, Shougen; Cao, Yongke

doi:10.1089/lap.2016.0636

Cited by 19 publications

(24 citation statements)

References 24 publications

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“…Regarding the learning curve study, previous research mostly focused on lobectomy. [23][24][25][26][27] In the UVIG report, 71% of the surgeons deemed the cut-off number as 50 cases were required to achieve the proficiency phase. 23 Studies reporting the learning curve of uniportal thoracoscopic segmentectomy are scarce.…”

Section: Discussionmentioning

confidence: 99%

The learning curve for uniportal video‐assisted thoracoscopic anatomical segmentectomy

Wan

et al. 2021

Journal of Surgical Oncology

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Objectives: The aim of this study is to evaluate the time course and caseload required to achieve proficiency by plotting the learning curve of uniportal thoracoscopic segmentectomy.Methods: We retrospectively analyzed the first 238 and 159 cases of uniportal thoracoscopic segmentectomy performed by two surgeons (A and B). The learning curves were assessed using cumulative sum analysis. Perioperative outcomes were evaluated as the learning curve developed. Two subtypes of this surgical approach, simple and complex segmentectomy, were separately analyzed.Results: Based on the learning curve, the inflection points occurred at 64 and 90 cases for surgeon A, 71 and 100 cases for surgeon B. Significantly longer operative time (p = .013), length of stay (p = .002), and drainage duration (p = .039) were observed between phase I and phase II compared to phase III for surgeon A.Operative times (p = .001) were significantly reduced for surgeon B. Furthermore, 26-28 and 52-56 cases were necessary to master the simple and complex segmentectomy, respectively.Conclusions: A total 64-71 cases were required to master uniportal thoracoscopic segmentectomy and 90-100 cases were necessary to achieve proficiency.

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Section: Discussionmentioning

confidence: 99%

The learning curve for uniportal video‐assisted thoracoscopic anatomical segmentectomy

Wan

et al. 2021

Journal of Surgical Oncology

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“…PRA has low complication and conversion rates, making it hard to use these outcome parameters alone to analyse the learning curve. In most previous studies, duration of operation was used to assess the learning curve. Therefore, operating time was chosen as the primary endpoint in analysis of the PRA learning curve in the present analysis.…”

Section: Discussionmentioning

confidence: 99%

Multicentre study evaluating the surgical learning curve for posterior retroperitoneoscopic adrenalectomy

Vrielink

Engelsman

Hemmer

et al. 2018

British Journal of Surgery

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“…With the same statistical division, Divisi and Zhao report their LC of VATS by dividing their lobectomies into 3 uniform groups based on their initial or late experience (13,14). On the other hand, many authors like Yao, Bedetti, Martin-Ucar, Gonfiotti and Cheng divide their cases into 2 groups: at the beginning and at the end of their period of study (15)(16)(17)(18)(19). Even if the distribution of the cases in the various phases reported in literature is quite uniform in several reports, we found some differences regarding the number of lobectomies necessary for good learning: Zhao reports that a surgeon becomes more proficient after 30-60 VATS lobectomies (14); Gonfiotti, Petersen, and Amore suggest a LC of 50 (18,20,21) while Yao, Cheng and Nachira refer 26, 28 and 25 lobectomies respectively as a LC for VATS (15,19,22).…”

Section: The Lc Of Vats Lobectomymentioning

confidence: 99%

Review of the learning curve of video-assisted thoracic surgery & robotic-assisted thoracic surgery lobectomies—similarities and differences

Paladini¹,

Meniconi²,

Ghisalberti³

et al. 2021

Curr Chall Thorac Surg

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Video-assisted thoracic surgery (VATS) and robotic-assisted thoracic surgery (RATS) are two different types of surgical approach for the treatment of early stage lung cancer. Technological innovations brought on the beginning of a new era in thoracic surgery in the last 20-30 years. A need for training led many thoracic surgery centers to study how the learning of these new techniques took place among their surgeons: the so-called learning curve (LC). This review aimed not only to evaluate the recent literature about the LC of these two minimally invasive techniques but also to point out what are the similarities and differences between the two techniques. We chose a total of 50 reports from papers published between 2008 and 2019: 30 about the LC of VATS lobectomy and 20 studies about the LC of RATS lobectomy. We observed a substantial overlap between the training of both techniques even though the LC of RATS appears to be shorter than VATS. There are common cornerstones in the two LCs like reduction of operating times, reduction of blood loss, more complete lymphadenectomy, conversion rate reduction; a minimum number of at least 50 cases for VATS and 20 cases for RATS are needed to overcome the initial phase of the LC. We noticed that the need for accessory thoracoscopic access is particularly reduced with experience in the LC of the single-port VATS while the evaluation of the docking time is uniquely taken into account for RATS as for the need of specific training for basic robotic skills.

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Video-Assisted Thoracic Surgical Lobectomy for Lung Cancer: Description of a Learning Curve

Abstract: Multidimensional statistical analyses suggested that the learning curve for VATS lobectomy for lung cancer required ∼26 cases. Favorable intraoperative and postoperative care parameters for VATS lobectomy were observed in the late-experience group.

Cited by 19 publications

References 24 publications

The learning curve for uniportal video‐assisted thoracoscopic anatomical segmentectomy

The learning curve for uniportal video‐assisted thoracoscopic anatomical segmentectomy

Multicentre study evaluating the surgical learning curve for posterior retroperitoneoscopic adrenalectomy

Review of the learning curve of video-assisted thoracic surgery & robotic-assisted thoracic surgery lobectomies—similarities and differences

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