Igai Hitoshi, Numajiri Kazuki, Ohsawa Fumi, Nii Kazuhito, Kamiyoshihara Mitsuhiro
Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, 389-1 Asakura-cho, Maebashi 371-0811, Gunma, Japan.
Cancers (Basel). 2023 Dec 29;16(1):184. doi: 10.3390/cancers16010184.
The aim of this retrospective study was to compare the learning curve and perioperative outcomes between the two approaches uVATS and RATS during their implementation periods.
The uVATS group included 77 consecutive uVATS segmentectomies performed by HI between February 2019 and June 2022, while the RATS group included 30 between July 2022 and September 2023. The patient characteristics, perioperative outcomes, and learning curves were compared between the two groups. The learning curve was evaluated using operative time and cumulative sum (CUSUM) analysis.
Most patient characteristics and perioperative outcomes were equivalent between the two groups. In the uVATS group, after a positive slope was observed until the 14th case (initial period), a plateau was observed until the 38th case (stable period). Finally, a negative slope was observed after the 38th case (proficiency period). In the RATS group, after a positive slope was observed until the 16th case (initial period), a plateau was observed until the 22nd case (stable period). Finally, a negative slope was observed after the 22nd case (proficiency period).
In segmentectomy, a surgeon reached the proficiency period earlier in RATS than in uVATS, although the trends to the stable period were similar.
本回顾性研究的目的是比较单孔电视辅助胸腔镜手术（uVATS）和机器人辅助胸腔镜手术（RATS）在实施期间的学习曲线和围手术期结果。
uVATS组包括2019年2月至2022年6月期间由HI连续进行的77例uVATS肺段切除术，而RATS组包括2022年7月至2023年9月期间的30例。比较两组患者的特征、围手术期结果和学习曲线。使用手术时间和累积和（CUSUM）分析评估学习曲线。
两组之间的大多数患者特征和围手术期结果相当。在uVATS组中，直到第14例（初期）观察到正斜率，直到第38例（稳定期）观察到平台期。最后，在第38例之后（熟练期）观察到负斜率。在RATS组中，直到第16例（初期）观察到正斜率，直到第22例（稳定期）观察到平台期。最后，在第22例之后（熟练期）观察到负斜率。
在肺段切除术中，尽管达到稳定期的趋势相似，但外科医生在RATS中比在uVATS中更早达到熟练期。
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