Learning Curve for Thoracoscopic Individual Basilar Segmentectomy: 18-Year Experience

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2023 Sep 16

PMID 37716932

Authors

Satoshi Takamori

Hiroyuki Oizumi

Jun Suzuki

Hikaru Watanabe

Kaito Sato

Satoshi Shiono

Ri Sho

Affiliations

Soon will be listed here.

Abstract

Background: Thoracoscopic anatomical individual basilar segmentectomy remains challenging owing to the deep intraparenchymal location of the hilar structures and anatomical variations. We analyzed and reported the experience and progress of thoracoscopic anatomical individual basilar segmentectomy at our university hospital.

Methods: We retrospectively examined the patients who underwent anatomical basilar segmentectomy at our institution from January 2004 to December 2021. We divided our analysis period into two parts: the first period (2004-2012) was the introductory period of video-assisted thoracoscopic surgery (VATS) segmentectomy, and the second period (2013-2021) was the maturity period of VATS segmentectomy. The learning curve of the leading surgeon in the second period was also evaluated based on the operative time and cumulative sum value of the operative time.

Results: Overall, 127 cases were evaluated, among whom 33 and 94 cases were assessed during the introductory and maturity periods of thoracoscopic segmentectomy, respectively. Age (P = 0.003) and Charlson comorbidity index (P = 0.002) were higher in the second period than in the first period. Use of a uniport (P = 0.006) was higher, and postoperative hospitalization duration (P = < 0.001) and operative time (P = 0.024) were shorter in the second period than in the first period. A learning curve obtained during the maturity period showed: The inflection point for the learning curve of thoracoscopic basilar segmentectomy was reached after 42 cases.

Conclusions: We have demonstrated a single institution's progress and learning curve for difficult segmentectomies. This may be helpful to institutions considering performing this surgery.

Citing Articles

Surgical outcomes and learning curve of complex versus simple segmentectomy for uniportal video-assisted thoracoscopic surgery: an initial experience of 100 cases of a single experienced surgeon.

Homma T, Saji H, Shimada Y, Tanabe K, Kojima K, Marushima H J Thorac Dis. 2024; 16(11):7361-7371.

PMID: 39678892 PMC: 11635227. DOI: 10.21037/jtd-24-1028.

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