Learning curve of totally thoracoscopic pulmonarysegmentectomy
作者机构：Department of Thoracic Surgery The First Affiliated Hospital of Nanjing Medical University Nanjing 210029 China
出 版 物：《Frontiers of Medicine》 (医学前沿（英文版）)
年 卷 期：2018年第12卷第5期
页 面：586-592页
核心收录：
基 金：This work was supported by the National Natural Science Foundation of China (No. 81572263) Natural Science Foundation of Jiangsu Province (No. BK20151584) Jiangsu Top Expert Program in Six Professions (No. WSW-028) Major Program of Science and Technology Foundation of Jiangsu Province (No. BE2016790) Jiangsu Medical Young Talent Project (No. QNRC2016566) the Program of Jiangsu Medical Innovation Team (No. CXTDA2017006) and Jiangsu Province 333 Talents Project (No. BRA2017545)
主 题：thoracoscopic segmentectomy learning curve CUSUM
摘 要：Totally thoracoscopic pulmonary segmentectomy (TTPS) is a feasible and safe technique that requires advanced thoracoscopic skills and knowledge of pulmonary anatomy. However, data describing the learning curve of TTPS have yet to be obtained. In this study, 128 patients who underwent TTPS between September 2010 and December 2013 were retrospectively analyzed to evaluate the learning curve and were divided chronologically into three phases, namely, ascending phase (A), plateau phase (B), and descending phase (C), through cumulative summation (CUSUM) for operative time (OT). Phases A, B, and C comprised 39, 33, and 56 cases, respectively. OT and blood loss decreased significantly from phases A to C (P 0.01), and the frequency of intraoperative bronchoscopy for target bronchus identification decreased gradually (A, 8/39; B, 4/33; C, 3/56; P = 0.06). No significant differences were observed in demographic factors, conversion, complications, hospital stay, and retrieved lymph nodes among the three phases. Surgical outcomes and techniques improved with experience and volume. CUSUMOT indicated that the learning curve of TTPS should be more than 72 cases.
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