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Learning curve of totally thoracoscopic pulmonary segmentectomy
Weibing Wu, Jing Xu, Wei Wen, Yue Yu, Xinfeng Xu, Quan Zhu, Liang Chen
《医学前沿（英文）》 2018年 第12卷 第5期 页码 586-592 doi: 10.1007/s11684-017-0566-z
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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《医学前沿（英文）》 2011年 第5卷 第1期 页码 53-60 doi: 10.1007/s11684-011-0121-2
Video-assisted thoracoscopic surgery (VATS) provides a new approach for treating early-stage lung cancer. Lobectomy by VATS has many advantages over conventional thoracotomy, such as shorter recovery time, less postoperative pain, and faster resumption of a normal lifestyle. However, there is still much debate on the role of VATS in lobectomy for the treatment of lung cancer. Concerns regarding safety, the extent of mediastinal lymph node dissection, and long-term survival have made some surgeons apprehensive of its validity for lung cancer. In this paper, we review the development of thoracoscopy, the present status of VATS for early stage of non-small cell lung cancer (NSCLC), and comparison between VATS and open thoracotomy in the management of NSCLC.
关键词： non-small cell lung cancer video-assisted thoracoscopic surgery lobectomy
标题 作者 时间 类型 操作
Learning curve of totally thoracoscopic pulmonary segmentectomy
Weibing Wu, Jing Xu, Wei Wen, Yue Yu, Xinfeng Xu, Quan Zhu, Liang Chen
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