文章：

在实施期间使用累积和分析法比较单孔与机器人胸腔镜肺段切除术的学习曲线

Comparison of the Learning Curve between Uniportal and Robotic Thoracoscopic Approaches in Pulmonary Segmentectomy during the Implementation Period Using Cumulative Sum Analysis

原文发布日期：29 December 2023

DOI: 10.3390/cancers16010184

类型: Article

开放获取: 是

英文摘要：

Background: The aim of this retrospective study was to compare the learning curve and perioperative outcomes between the two approaches uVATS and RATS during their implementation periods. Methods: The uVATS group included 77 consecutive uVATS segmentectomies performed by HI between February 2019 and June 2022, while the RATS group included 30 between July 2022 and September 2023. The patient characteristics, perioperative outcomes, and learning curves were compared between the two groups. The learning curve was evaluated using operative time and cumulative sum (CUSUMOT) analysis. Results: Most patient characteristics and perioperative outcomes were equivalent between the two groups. In the uVATS group, after a positive slope was observed until the 14th case (initial period), a plateau was observed until the 38th case (stable period). Finally, a negative slope was observed after the 38th case (proficiency period). In the RATS group, after a positive slope was observed until the 16th case (initial period), a plateau was observed until the 22nd case (stable period). Finally, a negative slope was observed after the 22nd case (proficiency period). Conclusions: In segmentectomy, a surgeon reached the proficiency period earlier in RATS than in uVATS, although the trends to the stable period were similar.

摘要翻译： 

背景：本回顾性研究旨在比较单孔电视辅助胸腔镜手术（uVATS）与机器人辅助胸腔镜手术（RATS）两种术式在临床应用初期的学习曲线及围手术期结果。方法：uVATS组纳入2019年2月至2022年6月期间由HI医师连续完成的77例uVATS肺段切除术，RATS组纳入2022年7月至2023年9月期间完成的30例RATS肺段切除术。比较两组患者的基线特征、围手术期结果及学习曲线，其中学习曲线通过手术时间与累积和（CUSUMOT）分析法进行评估。结果：两组多数患者特征及围手术期结果基本相当。在uVATS组中，学习曲线呈现三个阶段：前14例为上升期（初始阶段），第15至38例进入平台期（稳定阶段），第38例后转为下降期（熟练阶段）。在RATS组中，前16例为上升期（初始阶段），第17至22例进入平台期（稳定阶段），第22例后转为下降期（熟练阶段）。结论：在肺段切除术中，虽然两种术式达到稳定阶段的趋势相似，但外科医师通过RATS达到熟练阶段的时间早于uVATS。

原文链接：

Comparison of the Learning Curve between Uniportal and Robotic Thoracoscopic Approaches in Pulmonary Segmentectomy during the Implementation Period Using Cumulative Sum Analysis