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Impact of prior thoracoscopic experience on the learning curve of robotic McKeown esophagectomy: a multidimensional analysis
DC Field | Value | Language |
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dc.contributor.author | 김대준 | - |
dc.contributor.author | 박성용 | - |
dc.date.accessioned | 2022-12-22T02:59:56Z | - |
dc.date.available | 2022-12-22T02:59:56Z | - |
dc.date.issued | 2022-08 | - |
dc.identifier.issn | 0930-2794 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/191762 | - |
dc.description.abstract | Purpose: Left upper mediastinal lymph node dissection (UMLND)-a technically demanding step of McKeown esophagectomy-is frequently complicated by recurrent laryngeal nerve (RLN) palsy. Under the hypothesis that robotic esophagectomy (RE) could increase the safety and feasibility of UMLND, we retrospectively investigated the degree to which a pre-existing experience in video-assisted thoracoscopic esophagectomy (VATE) may affect the learning curves of this critical part of RE. Methods: Surgeon A had previously performed > 150 VATE procedures before transitioning to RE. While surgeon B had previously assisted to 50 RE, his pre-existing VATE experience consisted of less than five procedures. A total of 103 and 76 McKeown RE procedures were performed by surgeons A and B, respectively. The learning curve of left UMLND for each surgeon was examined using the cumulative sum method. Results: The inflection point of RLN palsy for surgeon A occurred at patient 31. While the nerve palsy rate decreased from 32.3 to 4.2% (p < 0.001), the number of nodes harvested during left UMLND did not appreciably change. Surgeon B showed a bimodal learning curve for RLN palsy with primary and secondary inflection points at patients 15 and 49, respectively. The RLN palsy rate initially decreased from 66.7% (patients 1-15) to 14.7% (patients 16-49), followed by an additional decline to 3.7% (patients 50-76). However, the number of nodes harvested during left UMLND showed a downtrend which was paralleled by decreasing rates of RLN palsy. These results indicate that surgeon B has not yet reached an ideal balance between an extensive UMLND and nerve protection. Conclusion: The pre-existing VATE experience seems to affect the learning curves of left UMLND during RE. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Springer | - |
dc.relation.isPartOf | SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Esophageal Neoplasms* / surgery | - |
dc.subject.MESH | Esophagectomy / methods | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Learning Curve | - |
dc.subject.MESH | Lymph Node Excision / methods | - |
dc.subject.MESH | Recurrent Laryngeal Nerve / pathology | - |
dc.subject.MESH | Retrospective Studies | - |
dc.subject.MESH | Robotic Surgical Procedures* / methods | - |
dc.subject.MESH | Vocal Cord Paralysis* / etiology | - |
dc.title | Impact of prior thoracoscopic experience on the learning curve of robotic McKeown esophagectomy: a multidimensional analysis | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) | - |
dc.contributor.googleauthor | Ming-Ju Hsieh | - |
dc.contributor.googleauthor | Seong Yong Park | - |
dc.contributor.googleauthor | Yun-Wen Wen | - |
dc.contributor.googleauthor | Dae Joon Kim | - |
dc.contributor.googleauthor | Chien-Hung Chiu | - |
dc.contributor.googleauthor | Yin-Kai Chao | - |
dc.identifier.doi | 10.1007/s00464-022-09050-y | - |
dc.contributor.localId | A00368 | - |
dc.relation.journalcode | J02703 | - |
dc.identifier.eissn | 1432-2218 | - |
dc.identifier.pmid | 35075527 | - |
dc.identifier.url | https://link.springer.com/article/10.1007/s00464-022-09050-y | - |
dc.subject.keyword | Learning curve | - |
dc.subject.keyword | Recurrent laryngeal nerve palsy | - |
dc.subject.keyword | Robotic esophagectomy | - |
dc.subject.keyword | Thoracoscopic esophagectomy | - |
dc.subject.keyword | Upper mediastinal lymph node dissection | - |
dc.contributor.alternativeName | Kim, Dae Joon | - |
dc.contributor.affiliatedAuthor | 김대준 | - |
dc.citation.volume | 36 | - |
dc.citation.number | 8 | - |
dc.citation.startPage | 5635 | - |
dc.citation.endPage | 5643 | - |
dc.identifier.bibliographicCitation | SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.36(8) : 5635-5643, 2022-08 | - |
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