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Learning curve for robotic thyroidectomy using BABA: CUSUM analysis of a single surgeon's experience
Hui Ouyang1, Wenbo Xue1,2, Zeyu Zhang1
1Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China.
Frontiers in Endocrinology
|September 19, 2022
Summary
Robotic thyroidectomy via the bilateral axillary breast approach (BABA RT) demonstrated comparable safety and oncologic outcomes to open surgery. Learning curves for BABA RT were established, with operative time indicating surgeon proficiency.
Area of Science:
- Surgical Oncology
- Robotic Surgery
- Endocrine Surgery
Background:
- Assessing safety and oncologic outcomes of robotic thyroidectomy via the bilateral axillary breast approach (BABA RT).
- Evaluating the learning curves associated with BABA RT compared to conventional open procedures.
Purpose of the Study:
- To compare the technical safety and oncologic outcomes of BABA RT with conventional open thyroidectomy.
- To determine the learning curve for BABA RT.
Main Methods:
- 1:1 matched analysis comparing BABA RT and conventional open thyroidectomy.
- Cumulative summation analysis to assess learning curves.
Main Results:
- No significant differences in general characteristics, short-term outcomes, central lymph node retrieval, or recurrence rates.
- Robotic BABA had fewer lateral lymph nodes retrieved; learning curves estimated at 15 (workspace), 30 (lobectomy), and 20 (total thyroidectomy) cases.
- No differences between learning and proficient groups, except for operation time.
Conclusions:
- Robotic thyroidectomy and neck dissection via BABA are feasible, safe, and oncologically sound.
- Operative time can serve as a criterion to gauge surgeon proficiency in BABA RT.
