Learning Curve for Transoral Endoscopic Thyroid Lobectomy.
Learning Curve for Transoral Endoscopic Thyroid Lobectomy.
复制标题
DOI：
10.1177/0194599818795881
复制
发表时间：
2018-10
期刊：
影响因子：
--
通讯作者：
Russell JO
中科院分区：
文献类型：
--
作者：
Razavi CR;Vasiliou E;Tufano RP;Russell JO
明确经前庭入路经口腔内窥镜甲状腺切除术(TOETVA)的学习曲线。有计划的数据收集的案例系列。三级护理学院医院。纳入的患者包括那些符合2015年美国甲状腺协会肺叶切除术指南的患者，以及我们小组之前记录的TOETVA适应症。手术时间(切开到缝合)作为操作熟练程度的替代指标，并绘制为病例数量的函数，以确定学习曲线。然后计算手术时间的简单移动平均值，熟练程度情况定义为该曲线斜率变化的病例数。比较了技能习得期(病例1至熟练病例)和熟练时期(其余病例)的人口学/特征数据、结果和并发症。然后使用线性回归模型计算和比较“手术时间与病例数”曲线图中技能习得和熟练程度阶段的斜率。手术成功率94%(29/30)，无永久性精神神经损伤和喉返神经损伤。熟练病例为病例11。在线性回归的斜率(分别为−16.7vs0.3P0.01)和中位手术时间(191vs119min)上，技能获得时间和熟练时间之间的差异有统计学意义(分别为−16.7vs0.03；P&t；.001)。不同时期的人口统计学、手术成功率或并发症发生率没有差异。本系列评估的外科医生的TOETVA学习曲线为11例。
To define the learning curve for transoral endoscopic thyroidectomy via the vestibular approach (TOETVA). Case series with planned data collection. Tertiary care academic hospital. Included patients were those who met the 2015 American Thyroid Association guidelines for lobectomy and our group’s previously documented indications for TOETVA. Operative time (incision to closure) was used as a surrogate for procedural proficiency and plotted as a function of case number to determine a learning curve. A simple moving average of operative time was then calculated, with the proficiency case defined as the case number where the slope of this curve changed. Demographic/characteristic data, outcomes, and complications were compared between the skill acquisition period (case 1 to proficiency case) and the proficiency period (remaining cases). A linear regression model was then used to calculate and compare the slopes of the skill acquisition and proficiency periods in the “operative time versus case number” plot. Thirty cases were attempted, with a procedural success rate of 29 of 30 (94%) and no incidence of permanent mental nerve or recurrent laryngeal nerve injury. The proficiency case was case 11. There was a statistically significant difference between the skill acquisition and proficiency periods in slopes of the linear regressions (−16.7 vs −0.3, respectively; P< .001) and median operative times (191 vs 119 minutes, P < .001). There was no difference in demographics, procedural success rate, or complication rate between the periods. The learning curve for TOETVA was 11 cases for the surgeon evaluated in this series.
登录
查看更多内容
影响因子：
1.6
作者：
Choi Y;Lee JH;Kim YH;Lee YS;Chang HS;Park CS;Roh MR
通讯作者：
Roh MR
DOI：
10.1097/sle.0b013e3182266dd6
发表时间：
2011-08-01
影响因子：
1
作者：
Terris, David J.;Singer, Michael C.;Seybt, Melanie W.
通讯作者：
Seybt, Melanie W.
影响因子：
3.7
作者：
Lee, Jandee;Yun, Jong Ho;Chung, Woong Youn
通讯作者：
Chung, Woong Youn
影响因子：
1.8
作者：
Razavi, Christopher R.;Tufano, Ralph P.;Russell, Jonathon O.
通讯作者：
Russell, Jonathon O.
影响因子：
6.6
作者：
Berber, Eren;Bernet, Victor;Terris, David J.
通讯作者：
Terris, David J.