Evaluating the Learning Curve and Patient Outcomes in Endoscopically Assisted Craniosynostosis Surgery: A 20-Year...

To analyze the learning curve associated with endoscopic-assisted craniosynostosis surgery (EACS) at a single institution over a period of 2 decades.

Patients who underwent EACS between 2004 and 2023 were included in this retrospective study. The impact of surgical experience was assessed by analyzing the duration of surgery and anesthesia, blood loss, need for blood transfusion, postoperative complications, and length of hospital stay, in relation to the number of surgeries performed.

On the basis of 310 patients, the overall complication rate was low, with only 23 patients (7.4%) experiencing postoperative complications and 33 patients (10.6%) requiring a blood transfusion. The median length of hospital stay was 3 days (range 1-7 days). The results showed a statistically significant learning curve associated with EACS, with each additional surgery reducing the odds of postoperative complications by 0.7% ( P <0.001) and the odds of blood transfusion by 0.8% ( P <0.001). In addition, there were significant reductions in the duration of anesthesia, duration of surgery, and length of hospital stay over time ( P <0.001).

EACS is a safe and effective technique for treating craniosynostosis with low complication rates and a significant learning curve over time. Surgeons can expect to achieve better outcomes with greater surgical experience.