TY - JOUR 
A1 - Wu, Ching Feng
AU - Paradela de la Morena, Marina
AU - Wu, Ching Yang
AU - de la Torre Bravos, Mercedes
AU - Fernández Prado, Ricardo
AU - Delgado Roel, María
AU - Fieira Costa, Eva María
AU - Hsieh, Ming Ju
AU - Chao, Yin Kai
AU - Yang, Lan Yan
AU - Pan, Yu Bin
AU - González Rivas, Diego
T1 - Novice training: The time course for developing competence in single port video-assisted thoracoscopic lobectomy
Y1 - 2020
SN - 0025-7974
UR - http://hdl.handle.net/20.500.11940/16263
AB - The competency in video-assisted thoracoscopic (VATS) lobectomy is expected to be achieved after surgeons practiced 30 to 50 cases according to previous reports. Does single port video-assisted thoracoscopic (SPVATS) lobectomy have a steeper learning curve and being harder to perform correctly, leading to long development times and high defect rates?From January, 2014 to February, 2017, 8 individual surgeons (3 were novices, 5 were pioneers in SPVATS surgery) submitted their cases chronologically to evaluate the learning curve of SPVATS lobectomy. Operating time (OT) was set as a surrogate marker for surgical competency. Postoperative outcomes and OT between the 2 groups were compared using propensity score matching (1:1 nearest neighbor). The learning curve for OT was evaluated using the cumulative sum (CUSUM) method.In the entire study cohort, a total of 356 cases were included (93 in junior consultant group [group A], 263 in senior consultant group [group B]). There were no significant differences between the 2 groups in operative time, conversion rate, postoperative complication rate, 30 and 90 days mortality rate. After propensity-score matching (86 pairs), operative time was longer in group A (214.33 +/- 62.18 vs 183.62 +/- 61.25 minutes, P = .001). Two-year overall survival rate was similar among 2 groups (P = .409). Competency was reached after junior surgeon completed 30th case of SPVATS lobectomy.SPVATS lobectomy is safe for the novice surgeon who wants to adopt this new surgical approach under well-developed training program. The learning curves for competence in SPVATS lobectomy are similar to VATS lobectomy in our series.
KW - Thoracic Surgery
KW - Lung Neoplasms
KW - Middle Aged
KW - Humans
KW - Learning Curve
KW - Pneumonectomy
KW - Operative Time
KW - Aged
KW - Postoperative Complications
KW - complicaciones postoperatorias
KW - cirugía torácica
KW - neumonectomía
KW - anciano
KW - tiempo quirúrgico
KW - curva de aprendizaje
KW - mediana edad
KW - humanos
KW - neoplasias pulmonares
KW - Aged
KW - Humans
KW - Learning Curve
KW - Lung Neoplasms
KW - Middle Aged
KW - Operative Time
KW - Pneumonectomy
KW - Postoperative Complications
KW - Thoracic Surgery, Video-Assisted
KW - CHUAC
ER -