Learning curve for electromagnetic navigation bronchoscopy-guided microwave ablation: a cumulative sum analysis.

Area of Science:

• Pulmonology
• Interventional Pulmonology
• Oncology

Background:

• Electromagnetic navigation bronchoscopy (ENB) combined with transbronchial microwave ablation (MWA) shows promise for treating pulmonary nodules.
• The learning curve for this combined technique is not well-established.

Purpose of the Study:

• To analyze the learning curve of ENB-guided MWA for pulmonary nodule treatment.
• To assess the proficiency progression of beginner operators using this technique.

Main Methods:

• Retrospective analysis of clinical data from patients treated with ENB-guided MWA by two beginner operators.
• Cumulative sum (CUSUM) method used to analyze learning curves for operation time and success rate.
• Evaluation of operation time, success rate, and complication rates.

Main Results:

• Operation time learning curves showed change points at 33 and 40 cases for the two operators.
• Success rate learning curves indicated initial trend reversal at 13 and 22 cases, with acceptable failure rates achieved by 48 and 55 cases.
• Complication rates were not significantly different from acceptable benchmarks.

Conclusions:

• ENB-guided MWA is a safe and relatively easy-to-learn technique for pulmonary nodules.
• The findings suggest potential for broader clinical adoption of this procedure.
• Further multi-center studies are recommended to validate these results with more operators.