초록접수 현황
| 19F-066 | 구연 미채택시 포럼 발표 |
Learning Curve of Uniportal VATS Lobectomy and Systemic Lymph Nodes Dissection: A Novice Surgeon Experience in a Middle Volume Center
Kim Jong Hun, Kim Tae Yun, Kim Kyung Hwa, Lee Jeong Moon
Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital, Chonbuk National University College of Medicine, Jeollabuk-do, Republic of Korea
Purpose : Uniportal video-assisted thoracopic (U-VATS) became the attractive procedure in major pulmonary resection recently, which reduces postoperative pain and hospital stay. Many thoracic surgeons consider U-VATS more complicated and challenging procedure than multiportal VATS (M-VATS) as ever. In this study, we evaluated of the early learning curve of the U-VATS lobectomy and systemic LNs dissection by a novice surgeon with a little experience of two ports VATS lobectomy.
Methods : From February 2018 U-VATS lobectomy and systemic LNs dissection was started in our institution. Consecutive seventy six patients who underwent the same procedure for lung cancer treatment until July 2019 were enrolled in the study. Learning curve was evaluated with cumulative failure charting and cumulative sum. Pre- and Post-operative outcomes were analyzed.
Results : The median age of the consecutive patients was 65.89 ± 9.4 years. Cross point was found at 38th patient in the cumulative failure charting. The correlation of operative time and consecutive number of the procedure was identified significantly (Pearson correlation coefficient (r): -0.344, Ρ=0.02). Mean operative time was 157.2 ± 46.8. There was one thoracotomy conversion due to pulmonary artery injury. Mean harvested LN number was 25.5 ± 8.6. A total of fifteen patients (19.7%) developed complications with 8 of prolonged air leak, 3 of pneumonia, a chylothorax, a vocal cord palsy, 2 of gastrointestinal problem, a acute kidney injury (AKI). One mortality was occurred from AKI.
Conclusion : Learning curve of U-VATs lobectomy and LNs dissection by a novice surgeon without enough experience of M-VATs is acceptably short with reasonable postoperative outcomes.
Methods : From February 2018 U-VATS lobectomy and systemic LNs dissection was started in our institution. Consecutive seventy six patients who underwent the same procedure for lung cancer treatment until July 2019 were enrolled in the study. Learning curve was evaluated with cumulative failure charting and cumulative sum. Pre- and Post-operative outcomes were analyzed.
Results : The median age of the consecutive patients was 65.89 ± 9.4 years. Cross point was found at 38th patient in the cumulative failure charting. The correlation of operative time and consecutive number of the procedure was identified significantly (Pearson correlation coefficient (r): -0.344, Ρ=0.02). Mean operative time was 157.2 ± 46.8. There was one thoracotomy conversion due to pulmonary artery injury. Mean harvested LN number was 25.5 ± 8.6. A total of fifteen patients (19.7%) developed complications with 8 of prolonged air leak, 3 of pneumonia, a chylothorax, a vocal cord palsy, 2 of gastrointestinal problem, a acute kidney injury (AKI). One mortality was occurred from AKI.
Conclusion : Learning curve of U-VATs lobectomy and LNs dissection by a novice surgeon without enough experience of M-VATs is acceptably short with reasonable postoperative outcomes.
책임저자: Kim Jong Hun
Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital, Chonbuk National University College of Medicine, Jeollabuk-do, Republic of Korea
발표자: Kim Jong Hun, E-mail : kim77jh@gmail.com