Department of Thoracic and Cardiovascular Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
J Laparoendosc Adv Surg Tech A. 2022 Jun;32(6):606-611. doi: 10.1089/lap.2021.0469. Epub 2021 Oct 28.
The aim of our study is to describe the learning curve for uniportal video-assisted thoracoscopic surgery (VATS) lobectomy from our single center's experience for adopting it because uniportal VATS is generally considered a technically difficult procedure. A retrospective review of all 164 consecutive patients who underwent uniportal VATS lobectomy between June 2015 and February 2020 was done. A cumulative summation (CUSUM) method was applied to evaluate the learning curves of the operation time. Among the 164 patients, the CUSUM value inflected at the 31st case. Ninety-five consecutive patients underwent uniportal VATS upper lobectomy. The other 69 consecutive patients underwent uniportal VATS lower lobectomy. The operation time CUSUM learning curve analysis revealed that the curves descended from the 21st case in upper lobectomy group and the 12th case in lower lobectomy group. Operators are required to experience at least 21 cases for upper lobectomy and 12 cases for lower lobectomy until the operation time is stabilized.
我们的研究目的是描述我们单中心采用单端口电视辅助胸腔镜手术（VATS）肺叶切除术的学习曲线，因为单端口 VATS 通常被认为是一项技术难度较大的手术。对 2015 年 6 月至 2020 年 2 月期间接受单端口 VATS 肺叶切除术的 164 例连续患者进行了回顾性分析。采用累积和（CUSUM）方法评估手术时间的学习曲线。在 164 例患者中，CUSUM 值在第 31 例时发生转折。95 例连续患者接受了单端口 VATS 上肺叶切除术，69 例连续患者接受了单端口 VATS 下肺叶切除术。手术时间 CUSUM 学习曲线分析显示，在上肺叶切除术组中，曲线从第 21 例下降，在下肺叶切除术组中，曲线从第 12 例下降。术者在上肺叶切除术方面需要至少经历 21 例，在下肺叶切除术方面需要至少经历 12 例，直到手术时间稳定。
