Head and Neck Surgery Department, Hôpital Lariboisière, Paris, France.
Head Neck. 2013 Aug;35(8):1078-82. doi: 10.1002/hed.23081. Epub 2012 Jul 12.
The purpose of this study was to evaluate the learning curve for minimally invasive video-assisted thyroidectomy (MIVAT).
Fifty consecutive patients were prospectively included in groups corresponding to their surgical order (10 patients in each group).
The mean operation times between 2 neighboring groups were 33.9 minutes longer in group 1 than in group 2 (p = .01) and 25.8 minutes longer in group 3 than in group 4 (p = .002). The conversion rate for technical difficulties in group 1 was 6% (3 of 50). The definitive complication rate was 2% (1 of 50).
In terms of operative time, 10 patients represented the early stage of the learning curve, and 30 patients represented the number of procedures required to reach an advanced level of skill. Considering the low conversion and complication rates, improved aesthetic results and postoperative course, MIVAT should become a tool in the repertoire of high-volume thyroid surgeons.
本研究旨在评估微创视频辅助甲状腺切除术(MIVAT)的学习曲线。
50 例连续患者前瞻性地分为手术顺序对应的组(每组 10 例)。
相邻两组之间的平均手术时间,第 1 组比第 2 组长 33.9 分钟(p =.01),第 3 组比第 4 组长 25.8 分钟(p =.002)。第 1 组因技术困难而中转的比例为 6%(3/50)。确诊并发症发生率为 2%(1/50)。
就手术时间而言,10 例患者代表学习曲线的早期阶段,30 例患者代表达到熟练水平所需的手术次数。考虑到较低的中转和并发症发生率、改善的美容效果和术后过程,MIVAT 应该成为高容量甲状腺外科医生的工具。