Learning curve of uniportal video-assisted lobectomy: Analysis of 15-month experience in a single center

Dania Nachira, Elisa Meacci, Venanzio Porziella, Maria Letizia Vita, Maria Teresa Congedo, Marco Chiappetta, Leonardo Petracca Ciavarella, Mahmoud Ismail, Elisabetta Gualtieri, Alfredo Cesario, Stefano Margaritora

Research output: Contribution to journalArticle

Abstract

Background: Uniportal video-assisted thoracoscopic (U-VATS) lobectomy has been becoming the technique of choice in an increasing number of centers. The aim of our study was to review our experience, evaluating the learning curve of U-VATS for lung lobectomy and outcomes. Methods: The prospectively collected clinical data of 43 consecutive patients, undergone U-VATS lobectomy from June 2016 to September 2017, were reviewed. The cumulative sum analysis was applied for defining the completion of learning curve (CLC), evaluating the relationship between operative time and the consecutive number of operations. Results: The mean operative time of Uniportal VATS lobectomy was 179.93±43.41 min. According to the cumulative sum analysis, the CLC was reached after 25 patients. Using the cut-off of 25 patients, the whole populations was divided in group A (first 25 patients of the experience) and group B (the last 18 patients). The mean operative time in group B was significantly shorter than in group A (164.00±24.46 vs. 191.40±50.45 min, respectively, P=0.04). There were no differences in demographic characteristics, number of removed lymph nodes, chest tube duration, and hospital stay among the two groups. The number of conversions was higher in group A (4 vs. 0; P=0.07), as the number of major complications, like reoperations for bleeding (2 vs. 0; P=0.22). There was no postoperative 30-day-related death. Conclusions: U-VATS lobectomy seems to be a quite safe and feasible procedure, with a steep learning curve and low complication rate, if performed by experienced surgeons after proper training.

Original languageEnglish
Pages (from-to)S3662-S3669
JournalJournal of Thoracic Disease
Volume10
DOIs
Publication statusPublished - Nov 1 2018

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Learning Curve
Operative Time
Video-Assisted Thoracic Surgery
Chest Tubes
Reoperation
Length of Stay
Lymph Nodes
Demography
Hemorrhage
Lung
Population

Keywords

  • Learning curve
  • Lung cancer
  • Lung major resections
  • Uniportal video-assisted thoracoscopic (U-VATS)

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Learning curve of uniportal video-assisted lobectomy : Analysis of 15-month experience in a single center. / Nachira, Dania; Meacci, Elisa; Porziella, Venanzio; Vita, Maria Letizia; Congedo, Maria Teresa; Chiappetta, Marco; Ciavarella, Leonardo Petracca; Ismail, Mahmoud; Gualtieri, Elisabetta; Cesario, Alfredo; Margaritora, Stefano.

In: Journal of Thoracic Disease, Vol. 10, 01.11.2018, p. S3662-S3669.

Research output: Contribution to journalArticle

Nachira, Dania ; Meacci, Elisa ; Porziella, Venanzio ; Vita, Maria Letizia ; Congedo, Maria Teresa ; Chiappetta, Marco ; Ciavarella, Leonardo Petracca ; Ismail, Mahmoud ; Gualtieri, Elisabetta ; Cesario, Alfredo ; Margaritora, Stefano. / Learning curve of uniportal video-assisted lobectomy : Analysis of 15-month experience in a single center. In: Journal of Thoracic Disease. 2018 ; Vol. 10. pp. S3662-S3669.
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T2 - Analysis of 15-month experience in a single center

AU - Nachira, Dania

AU - Meacci, Elisa

AU - Porziella, Venanzio

AU - Vita, Maria Letizia

AU - Congedo, Maria Teresa

AU - Chiappetta, Marco

AU - Ciavarella, Leonardo Petracca

AU - Ismail, Mahmoud

AU - Gualtieri, Elisabetta

AU - Cesario, Alfredo

AU - Margaritora, Stefano

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: Uniportal video-assisted thoracoscopic (U-VATS) lobectomy has been becoming the technique of choice in an increasing number of centers. The aim of our study was to review our experience, evaluating the learning curve of U-VATS for lung lobectomy and outcomes. Methods: The prospectively collected clinical data of 43 consecutive patients, undergone U-VATS lobectomy from June 2016 to September 2017, were reviewed. The cumulative sum analysis was applied for defining the completion of learning curve (CLC), evaluating the relationship between operative time and the consecutive number of operations. Results: The mean operative time of Uniportal VATS lobectomy was 179.93±43.41 min. According to the cumulative sum analysis, the CLC was reached after 25 patients. Using the cut-off of 25 patients, the whole populations was divided in group A (first 25 patients of the experience) and group B (the last 18 patients). The mean operative time in group B was significantly shorter than in group A (164.00±24.46 vs. 191.40±50.45 min, respectively, P=0.04). There were no differences in demographic characteristics, number of removed lymph nodes, chest tube duration, and hospital stay among the two groups. The number of conversions was higher in group A (4 vs. 0; P=0.07), as the number of major complications, like reoperations for bleeding (2 vs. 0; P=0.22). There was no postoperative 30-day-related death. Conclusions: U-VATS lobectomy seems to be a quite safe and feasible procedure, with a steep learning curve and low complication rate, if performed by experienced surgeons after proper training.

AB - Background: Uniportal video-assisted thoracoscopic (U-VATS) lobectomy has been becoming the technique of choice in an increasing number of centers. The aim of our study was to review our experience, evaluating the learning curve of U-VATS for lung lobectomy and outcomes. Methods: The prospectively collected clinical data of 43 consecutive patients, undergone U-VATS lobectomy from June 2016 to September 2017, were reviewed. The cumulative sum analysis was applied for defining the completion of learning curve (CLC), evaluating the relationship between operative time and the consecutive number of operations. Results: The mean operative time of Uniportal VATS lobectomy was 179.93±43.41 min. According to the cumulative sum analysis, the CLC was reached after 25 patients. Using the cut-off of 25 patients, the whole populations was divided in group A (first 25 patients of the experience) and group B (the last 18 patients). The mean operative time in group B was significantly shorter than in group A (164.00±24.46 vs. 191.40±50.45 min, respectively, P=0.04). There were no differences in demographic characteristics, number of removed lymph nodes, chest tube duration, and hospital stay among the two groups. The number of conversions was higher in group A (4 vs. 0; P=0.07), as the number of major complications, like reoperations for bleeding (2 vs. 0; P=0.22). There was no postoperative 30-day-related death. Conclusions: U-VATS lobectomy seems to be a quite safe and feasible procedure, with a steep learning curve and low complication rate, if performed by experienced surgeons after proper training.

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