Learning curve of robotic portal lobectomy for pulmonary neoplasms: A prospective observational study.
Thorac Cancer
; 12(9): 1431-1440, 2021 05.
Article
in En
| MEDLINE
| ID: mdl-33709571
ABSTRACT
BACKGROUND:
We aim to assess the learning curve of robotic portal lobectomy with four arms (RPL-4) in patients with pulmonary neoplasms using prospectively collected data.METHODS:
Data from 100 consecutive cases with lung neoplasms undergoing RPL-4 were prospectively accumulated into a database between June 2018 and August 2019. The Da Vinci Si system was used to perform RPL-4. Regression curves of cumulative sum analysis (CUSUM) and risk-adjusted CUSUM (RA-CUSUM) were fit to identify different phases of the learning curve. Clinical indicators and patient characteristics were compared between different phases.RESULTS:
The mean operative time, console time, and docking time for the entire cohort were 130.6 ± 53.8, 95.5 ± 52.3, and 6.4 ± 3.0 min, respectively. Based on CUSUM analysis of console time, the surgical experience can be divided into three different phases 1-10 cases (learning phase), 11-51 cases (plateau phase), and >51 cases (mastery phase). RA-CUSUM analysis revealed that experience based on 56 cases was required to truly master this technique. Total operative time (p < 0.001), console time (p < 0.001), and docking time (p = 0.026) were reduced as experience increased. However, other indicators were not significantly different among these three phases.CONCLUSIONS:
The RPL-4 learning curve can be divided into three phases. Ten cases were required to pass the learning curve, but the mastery of RPL-4 for satisfactory surgical outcomes requires experience with at least 56 cases.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Anterior Temporal Lobectomy
/
Robotic Surgical Procedures
/
Lung Neoplasms
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Thorac Cancer
Year:
2021
Document type:
Article
Affiliation country:
China