Learning curve for robot-assisted Mckeown esophagectomy in patients with thoracic esophageal cancer.

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2024-12-10 DOI:10.1016/j.ejso.2024.109516

Ligong Yuan, Tianci Zhang, Xianning Wu

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引用次数: 0

Abstract

Background: Robot-assisted minimally invasive esophagectomy (RAMIE) is an effective but technically demanding procedure. The learning curve of RAMIE has been studied to help guide training and to ensure its safe implementation.

Methods: We retrospectively analyzed the first 83 consecutive patients with thoracic esophageal cancer who underwent robot-assisted minimally invasive Mckeown esophagectomy (RAMIE-MK) between May 2021 and August 2023, all performed by a single surgeon. A cumulative sum (CUSUM) analysis was applied to generate the learning curve of RAMIE-MK, based on total operation time.

Results: The learning curve was divided into two phases based on the CUSUM analysis: Phase I, the initial learning phase (cases 1-27) and Phase II, the proficiency phase (cases 28-83). When comparing the proficiency phase with the initial phase, we observed a significant decreased trends in total operation time (329.6 ± 71.0 min vs 221.3 ± 33.5 min, P＜0.001). No significant differences were found in other clinicopathological characteristics.

Conclusion: For a surgeon experienced in open and thoracolaparoscopic esophagectomy, and who also received systematic robot-assisted thoracic surgery training on animals, a total of 27 cases were required to gain technical proficiency in RAMIE-MK.

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胸腔食管癌患者机器人辅助麦氏食管切除术的学习曲线。

背景：机器人辅助微创食管切除术（RAMIE）是一种有效但技术要求高的手术。我们对 RAMIE 的学习曲线进行了研究，以帮助指导培训并确保其安全实施：我们回顾性分析了 2021 年 5 月至 2023 年 8 月间接受机器人辅助微创麦氏食管切除术（RAMIE-MK）的首批 83 例连续胸腔食管癌患者，所有手术均由一名外科医生完成。根据总手术时间，采用累积总和（CUSUM）分析法生成RAMIE-MK的学习曲线：结果：根据 CUSUM 分析，学习曲线分为两个阶段：第一阶段为初始学习阶段（案例 1-27），第二阶段为熟练阶段（案例 28-83）。将熟练阶段与初始阶段进行比较，我们发现总手术时间呈显著下降趋势（329.6 ± 71.0 min vs 221.3 ± 33.5 min，P＜0.001）。其他临床病理特征无明显差异：结论：对于一名在开胸和胸腔镜食管切除术方面经验丰富的外科医生来说，并且还在动物身上接受过系统的机器人辅助胸腔镜手术培训，总共需要27个病例才能熟练掌握RAMIE-MK技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.