Cusum analysis for learning curve of videothoracoscopic lobectomy

Area of Science:

• Thoracic Surgery
• Surgical Education
• Minimally Invasive Procedures

Background:

• Video-assisted thoracoscopic (VATS) lobectomy presents a steep learning curve due to technical challenges and bleeding risks.
• Determining the required case volume for surgical proficiency is crucial for patient safety and effective training.

Purpose of the Study:

• To assess the number of cases needed to achieve technical proficiency in VATS lobectomy for a single surgeon.
• To apply cumulative sum (CUSUM) analysis to evaluate the learning curve.

Main Methods:

• Utilized the CALGB definition for VATS lobectomy.
• Applied CUSUM analysis to operational duration and hospital stay for initial VATS lobectomy cases.
• Evaluated data from 58 patients undergoing VATS lobectomy.

Main Results:

• Proficiency in operation duration was achieved by the 27th case, as indicated by CUSUM analysis.
• The study included 58 patients, with 51 undergoing procedures for malignant conditions.

Conclusions:

• The learning curve for VATS lobectomy is influenced by prior surgical experience and surgeon capability.
• Technical proficiency may be attainable with fewer cases (around 27) than suggested by existing literature (50-200).