TY - JOUR
T1 - Learning curve of uniportal video-assisted lobectomy: Analysis of 15-month experience in a single center
AU - Nachira, Dania
AU - Meacci, Elisa
AU - Porziella, Venanzio
AU - Vita, Maria Letizia
AU - Congedo, Maria Teresa
AU - Chiappetta, Marco
AU - Petracca Ciavarella, Leonardo
AU - Ismail, Mahmoud
AU - Gualtieri, Elisabetta
AU - Cesario, Alfredo
AU - Margaritora, Stefano
PY - 2018
Y1 - 2018
N2 - Background: Uniportal video-assisted thoracoscopic (U-VATS) lobectomy has been becoming the technique of choice in an increasing number of centers. The aim of our study was to review our experience, evaluating the learning curve of U-VATS for lung lobectomy and outcomes. Methods: The prospectively collected clinical data of 43 consecutive patients, undergone U-VATS lobectomy from June 2016 to September 2017, were reviewed. The cumulative sum analysis was applied for defining the completion of learning curve (CLC), evaluating the relationship between operative time and the consecutive number of operations. Results: The mean operative time of Uniportal VATS lobectomy was 179.93±43.41 min. According to the cumulative sum analysis, the CLC was reached after 25 patients. Using the cut-off of 25 patients, the whole populations was divided in group A (first 25 patients of the experience) and group B (the last 18 patients). The mean operative time in group B was significantly shorter than in group A (164.00±24.46 vs. 191.40±50.45 min, respectively, P=0.04). There were no differences in demographic characteristics, number of removed lymph nodes, chest tube duration, and hospital stay among the two groups. The number of conversions was higher in group A (4 vs. 0; P=0.07), as the number of major complications, like reoperations for bleeding (2 vs. 0; P=0.22). There was no postoperative 30-day-related death. Conclusions: U-VATS lobectomy seems to be a quite safe and feasible procedure, with a steep learning curve and low complication rate, if performed by experienced surgeons after proper training.
AB - Background: Uniportal video-assisted thoracoscopic (U-VATS) lobectomy has been becoming the technique of choice in an increasing number of centers. The aim of our study was to review our experience, evaluating the learning curve of U-VATS for lung lobectomy and outcomes. Methods: The prospectively collected clinical data of 43 consecutive patients, undergone U-VATS lobectomy from June 2016 to September 2017, were reviewed. The cumulative sum analysis was applied for defining the completion of learning curve (CLC), evaluating the relationship between operative time and the consecutive number of operations. Results: The mean operative time of Uniportal VATS lobectomy was 179.93±43.41 min. According to the cumulative sum analysis, the CLC was reached after 25 patients. Using the cut-off of 25 patients, the whole populations was divided in group A (first 25 patients of the experience) and group B (the last 18 patients). The mean operative time in group B was significantly shorter than in group A (164.00±24.46 vs. 191.40±50.45 min, respectively, P=0.04). There were no differences in demographic characteristics, number of removed lymph nodes, chest tube duration, and hospital stay among the two groups. The number of conversions was higher in group A (4 vs. 0; P=0.07), as the number of major complications, like reoperations for bleeding (2 vs. 0; P=0.22). There was no postoperative 30-day-related death. Conclusions: U-VATS lobectomy seems to be a quite safe and feasible procedure, with a steep learning curve and low complication rate, if performed by experienced surgeons after proper training.
KW - Learning curve
KW - Lung cancer
KW - Lung major resections
KW - Pulmonary and Respiratory Medicine
KW - Uniportal video-assisted thoracoscopic (U-VATS)
KW - Learning curve
KW - Lung cancer
KW - Lung major resections
KW - Pulmonary and Respiratory Medicine
KW - Uniportal video-assisted thoracoscopic (U-VATS)
UR - http://hdl.handle.net/10807/132903
UR - http://www.jthoracdis.com/
U2 - 10.21037/jtd.2018.03.133
DO - 10.21037/jtd.2018.03.133
M3 - Article
SN - 2072-1439
VL - 10
SP - S3662-S3669
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
ER -