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01-03-2017 | Original Article

Short-term outcomes and one surgeon’s learning curve for thoracoscopic esophagectomy performed with the patient in the prone position

Authors: Taro Oshikiri, Takashi Yasuda, Hiroshi Hasegawa, Masashi Yamamoto, Shingo Kanaji, Kimihiro Yamashita, Takeru Matsuda, Yasuo Sumi, Tetsu Nakamura, Yasuhiro Fujino, Masahiro Tominaga, Satoshi Suzuki, Yoshihiro Kakeji

Published in: Surgery Today | Issue 3/2017

Abstract

Purpose

Thoracoscopic esophagectomy with the patient in the prone position (TEP) is now being performed as minimally invasive esophagectomy for esophageal cancer. This study examines the short-term outcomes and the learning curve associated with TEP.

Methods

One surgeon (“Surgeon A”) performed TEP on 100 consecutive patients assigned to three periods based on treatment order. Each group consisted of 33 or 34 patients. The outcomes of the three groups were compared to define the influence of surgeon expertise.

Results

Outcomes improved as Surgeon A gained experience in performing this operation, as evidenced by reduced thoracic operative times between periods 1 and 2, and then between periods 2 and 3 (p = 0.0033 and p = 0.0326, respectively); an increased number of retrieved chest nodes between periods 1 and 2 (p = 0.0070); and a decline in recurrent laryngeal nerve (RLN) palsy between periods 2 and 3 (p = 0.0450). Period 2 was the pivotal period for each learning curve.

Conclusions

An individual surgeon’s learning curve over the course of 100 TEP procedures had three outcomes: a shortened operative time, a higher number of retrieved chest nodes, and a decreased rate of RLN palsy. Approximately 30–60 cases were needed to reach a plateau in the TEP procedure and a reduction in the morbidity rate.

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Title: Short-term outcomes and one surgeon’s learning curve for thoracoscopic esophagectomy performed with the patient in the prone position
Authors: Taro Oshikiri
Takashi Yasuda
Hiroshi Hasegawa
Masashi Yamamoto
Shingo Kanaji
Kimihiro Yamashita
Takeru Matsuda
Yasuo Sumi
Tetsu Nakamura
Yasuhiro Fujino
Masahiro Tominaga
Satoshi Suzuki
Yoshihiro Kakeji
Publication date: 01-03-2017
Publisher: Springer Japan
Published in: Surgery Today / Issue 3/2017
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-016-1378-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Short-term outcomes and one surgeon’s learning curve for thoracoscopic esophagectomy performed with the patient in the prone position

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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