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单孔胸腔镜解剖性肺段切除术的学习曲线。

Learning Curve for Uniportal Thoracoscopic Anatomical Pulmonary Segmentectomy.

机构信息

206608Nanjing Chest Hospital, China.

56647Nanjing Medical University Affiliated Brain Hospital, China.

出版信息

Surg Innov. 2020 Aug;27(4):378-383. doi: 10.1177/1553350620932430. Epub 2020 Jun 16.

Abstract

. Video-assisted thoracoscopic segmentectomy has been considered to be an effective management in properly selected patients. Given the substantial technical difficulties, uniportal thoracoscopic segmentectomy is a challenging surgical procedure. The purpose of this study was to investigate the learning curve for uniportal thoracoscopic segmentectomy procedures. . Prospectively collected data were retrospectively analyzed for a series of 124 consecutive patients undergoing uniportal thoracoscopic segmentectomy from August 2016 to September 2018. The learning curve for uniportal thoracoscopic segmentectomy was studied using cumulative sum (CUSUM) combined with risk-adjusted cumulative sum (RA-CUSUM) methods. . According to the CUSUM combined with the RA-CUSUM analyses, the learning curve for uniportal thoracoscopic segmentectomy was composed of three well-differentiated phases: cases 1 to 24, cases 25 to 57, and cases 58 to 124. With the procedures proceeded orderly, the operation time tends to progressively decrease. . The uniportal thoracoscopic segmentectomy is considered to be a feasible and safe surgical procedure that can be taught to surgeons through a proctored learning curve. The data of the present study indicate that the inflection point for completion the learning curve was reached after a considerable number of 57 cases.

摘要

单孔胸腔镜肺段切除术被认为是一种有效的治疗方法,适用于选择合适的患者。由于存在实质性的技术难题,单孔胸腔镜肺段切除术是一种具有挑战性的手术操作。本研究旨在探讨单孔胸腔镜肺段切除术的学习曲线。

本研究回顾性分析了 2016 年 8 月至 2018 年 9 月期间连续 124 例接受单孔胸腔镜肺段切除术患者的前瞻性收集数据。使用累积和(CUSUM)结合风险调整累积和(RA-CUSUM)方法研究单孔胸腔镜肺段切除术的学习曲线。

根据 CUSUM 联合 RA-CUSUM 分析,单孔胸腔镜肺段切除术的学习曲线由三个明显不同的阶段组成:第 1 至 24 例,第 25 至 57 例,以及第 58 至 124 例。随着手术的有序进行,手术时间呈逐渐下降趋势。

单孔胸腔镜肺段切除术被认为是一种可行且安全的手术操作,可以通过监督学习曲线教授给外科医生。本研究的数据表明,在完成 57 例手术的相当数量后,达到了学习曲线的转折点。

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