Learning curve for full-port robot-assisted mediastinal mass resection: a single-centre retrospective study

The advent of da Vinci robotic technology has revolutionized the surgical management of mediastinal masses. However, research on the learning curve of full-port robot-assisted mediastinal mass resection remains limited. We conducted a retrospective analysis of 74 consecutive patients who underwent full-port robot-assisted mediastinal mass resection performed by a single surgeon at our center. We performed multiple linear regression analysis to evaluate and standardize the operative time (OT). Subsequently, the cumulative sum (CUSUM) control charts were constructed to compare learning curve models derived from standardized versus nonstandardized OT data. Finally, a systematic evaluation was conducted to assess the perioperative parameters. Lesion size and intraoperative blood loss were identified via multiple linear regression as significant factors influencing the OT (P < 0.05), with the OT standardized using regression coefficients. A CUSUM chart based on the OT was then generated. The learning curve model based on nonstandardized operative time data demonstrated an earlier peak than that derived from standardized data. Further analysis of the standardized operative time revealed a peak in the learning curve at the 33rd case. Cases 1-33 were classified as the learning phase and cases 34-74 as the proficiency phase. The mean OT in the proficiency phase was significantly shorter, and intraoperative blood loss was notably lower than that in the learning phase (P < 0.05 for both). However, no significant differences were identified between the two phases for other perioperative outcomes (P > 0.05).