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Impact of prior thoracoscopic experience on the learning curve of robotic McKeown esophagectomy: a multidimensional analysis

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dc.contributor.author김대준-
dc.contributor.author박성용-
dc.date.accessioned2022-12-22T02:59:56Z-
dc.date.available2022-12-22T02:59:56Z-
dc.date.issued2022-08-
dc.identifier.issn0930-2794-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/191762-
dc.description.abstractPurpose: 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.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherSpringer-
dc.relation.isPartOfSURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHEsophageal Neoplasms* / surgery-
dc.subject.MESHEsophagectomy / methods-
dc.subject.MESHHumans-
dc.subject.MESHLearning Curve-
dc.subject.MESHLymph Node Excision / methods-
dc.subject.MESHRecurrent Laryngeal Nerve / pathology-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRobotic Surgical Procedures* / methods-
dc.subject.MESHVocal Cord Paralysis* / etiology-
dc.titleImpact of prior thoracoscopic experience on the learning curve of robotic McKeown esophagectomy: a multidimensional analysis-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Thoracic and Cardiovascular Surgery (흉부외과학교실)-
dc.contributor.googleauthorMing-Ju Hsieh-
dc.contributor.googleauthorSeong Yong Park-
dc.contributor.googleauthorYun-Wen Wen-
dc.contributor.googleauthorDae Joon Kim-
dc.contributor.googleauthorChien-Hung Chiu-
dc.contributor.googleauthorYin-Kai Chao-
dc.identifier.doi10.1007/s00464-022-09050-y-
dc.contributor.localIdA00368-
dc.relation.journalcodeJ02703-
dc.identifier.eissn1432-2218-
dc.identifier.pmid35075527-
dc.identifier.urlhttps://link.springer.com/article/10.1007/s00464-022-09050-y-
dc.subject.keywordLearning curve-
dc.subject.keywordRecurrent laryngeal nerve palsy-
dc.subject.keywordRobotic esophagectomy-
dc.subject.keywordThoracoscopic esophagectomy-
dc.subject.keywordUpper mediastinal lymph node dissection-
dc.contributor.alternativeNameKim, Dae Joon-
dc.contributor.affiliatedAuthor김대준-
dc.citation.volume36-
dc.citation.number8-
dc.citation.startPage5635-
dc.citation.endPage5643-
dc.identifier.bibliographicCitationSURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.36(8) : 5635-5643, 2022-08-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers

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