Junior surgeons are quicker to master the single-port thoracoscopic lobectomy: comprehensive analysis of the learning curve and oncological outcomes

• Published in: World journal of surgical oncology 2023-04, Vol.21 (1), p.134-134, Article 134
• Main Authors: Liang, Mingqiang, Wu, Peixun, Xu, Chi, Zheng, Bin, Chen, Chun
• Format: Article
• Language: English
• Subjects: Analysis; Cardiac function; Care and treatment; Chest tubes; Diagnosis; Hospital utilization; Hospitals; Humans; Learning; Learning Curve; Learning curves; Length of stay; Lung cancer; Lung Neoplasms - surgery; Lymphatic system; Metastasis; Oncological outcome; Parameters; Patients; Pneumonectomy; Pneumonectomy - methods; Practice; Retrospective Studies; Single-port thoracoscopic lobectomy; Statistical analysis; Surgeons; Survival; Thoracic surgeons; Thoracic surgery; Thoracic Surgery, Video-Assisted - methods; Thorax; Tomography; Variables
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-023-03017-6

The learning curve of single-port thoracoscopic lobectomy (SPTL) in lung cancer has been widely studied. However, the efficiency of different experience levels of thoracic surgeons in mastering the learning curve is unknown. Hence, we discuss this issue in depth by using several perioperative parameters and oncological outcomes. A total of 120 consecutive cases of SPTL performed by a senior (STS group) and junior (JTS group) thoracic surgeons were retrospectively analyzed. Operation time, estimated blood loss, and duration of postoperative hospital stay were recorded for cumulative summation (CUSUM) learning curve analysis, while the 5-year survival rate was used for oncological evaluation. The CUSUM learning curve of the STS group was y = 0.000106x  - 0.019x  + 0.852x - 0.036, with a high R-value of 0.9517. When the number of cases exceeded 33, the slope changed from positive to negative. The CUSUM learning curve of the JTS group was y = 0.000266x  - 0.04x  + 1.429 × -0.335, with a high R-value of 0.9644. When the number of cases exceeded 25, the slope changed from positive to negative. The learning curve was divided into two phases (phases 1 and 2). The slope of the JTS group in phase 1 was greater than that of the STS group in phase 1 (p  0.05). In addition, the 5-year survival rate was not significantly different between the two groups (p = 0.72). This is the first study to analyze the learning curve of thoracic surgeons with different experience levels in mastering SPTL. Moreover, it is also the first study to include multiple perioperative parameters and overall survival to study how quickly surgeons master the SPTL technique. The junior thoracic surgeon was found to have a shorter learning curve for SPTL.