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单孔经腋窝机器人甲状腺切除术(SP-TART)的学习曲线:最初50例叶切除术的经验

The learning curve for single-port transaxillary robotic thyroidectomy (SP-TART): experience through initial 50 cases of lobectomy.

作者信息

Park Joonseon, Kang Ll Ku, Kim Kwangsoon, Bae Ja Seong, Kim Jeong Soo

机构信息

Department of Surgery, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-Gu, 06591, Seoul, Republic of Korea.

出版信息

Updates Surg. 2023 Apr;75(3):691-700. doi: 10.1007/s13304-022-01445-9. Epub 2022 Dec 19.

Abstract

The new da Vinci® single-port (SP) robotic system, which utilizes a smaller incision and work space compared to the previous versions, is suitable for thyroidectomy. This study aimed to evaluate the learning curve for SP transaxillary robotic thyroidectomy (SP-TART) in a single-center. Fifty consecutive patients who underwent SP-TART between October 2021 and April 2022 in Seoul St. Mary's Hospital in Seoul, Korea, were included in this retrospective analysis. We examined the clinicopathological characteristics and short-term surgical outcomes and assessed the learning curve for SP-TART using cumulative summation analysis. The mean operation time was 57.8 ± 14.1 min, and the mean tumor size was 1.0 ± 0.7 (range, 0.3-3.7) cm. The patients were discharged approximately 2 days after surgery, and only two (4%) patients developed postoperative complications, including drainage-site bleeding and surgical site infection. Risk factors for long operation time were thyroiditis, amount of blood loss, and lymph node metastasis. The learning curve for SP-TART was 20 cases for the experienced robotic surgeon. SP-TART is technically feasible and safe with a short incision length and short operation time. It is a valuable alternative operative option with good surgical outcomes and outstanding cosmetic results.

摘要

新型达芬奇®单孔(SP)机器人系统与以往版本相比,切口和工作空间更小,适用于甲状腺切除术。本研究旨在评估单中心SP经腋窝机器人甲状腺切除术(SP-TART)的学习曲线。对2021年10月至2022年4月期间在韩国首尔圣玛丽医院连续接受SP-TART手术的50例患者进行了这项回顾性分析。我们检查了临床病理特征和短期手术结果,并使用累积求和分析评估了SP-TART的学习曲线。平均手术时间为57.8±14.1分钟,平均肿瘤大小为1.0±0.7(范围0.3-3.7)厘米。患者术后约2天出院,只有两名(4%)患者出现术后并发症,包括引流部位出血和手术部位感染。手术时间长的危险因素为甲状腺炎、失血量和淋巴结转移。对于经验丰富的机器人外科医生来说,SP-TART的学习曲线为20例。SP-TART技术上可行且安全,切口长度短,手术时间短。它是一种有价值的替代手术选择,手术效果良好,美容效果出色。

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