Anastomotic time was associated with postoperative complications : a cumulative sum analysis of thoracoscopic repair of tracheoesophageal fistula in a single surgeon's experience

© 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd..

PURPOSE: This study aimed to evaluate the learning curve of thoracoscopic repair of tracheoesophageal fistula (TEF) by a single surgeon using a cumulative sum (CUSUM) analysis.

METHODS: Prospective clinical data of consecutive Gross type-C TEF repairs performed by a pediatric surgeon from 2010 to 2020 were recorded. CUSUM charts for anastomosis and operating times were generated. The learning curves were compared with the effect of accumulation based on case experience.

RESULTS: For 33 consecutive cases, the mean operative and anastomosis times were 139 ± 39 min and 3137 ± 1110 s, respectively. Significant transitions beyond the learning phase for total operating and anastomosis times were observed at cases 13 and 17. Both the total operating time and anastomosis time were significantly faster in the proficiency improvement phase than in the initial learning phase. Postoperative complications significantly decreased after the initial anastomosis learning phase but not after the initial total operating learning phase.

CONCLUSIONS: Thoracoscopic repair of TEF is considered safe and feasible after 13 cases, where the surgeon can improve their proficiency with the total operation procedure, and 17 cases, which will enable the surgeon to achieve proficiency in anastomosis. Postoperative complications significantly decreased after gaining familiarity with the anastomosis procedure through the learning phase.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:53

Enthalten in:

Surgery today - 53(2023), 12 vom: 15. Dez., Seite 1363-1371

Sprache:

Englisch

Beteiligte Personen:

Guo, Yaohui [VerfasserIn]
Hinoki, Akinari [VerfasserIn]
Deie, Kyoichi [VerfasserIn]
Tainaka, Takahisa [VerfasserIn]
Sumida, Wataru [VerfasserIn]
Makita, Satoshi [VerfasserIn]
Okamoto, Masamune [VerfasserIn]
Takimoto, Aitarou [VerfasserIn]
Yasui, Akihiro [VerfasserIn]
Takada, Shunya [VerfasserIn]
Nakagawa, Yoichi [VerfasserIn]
Kato, Daiki [VerfasserIn]
Maeda, Takuya [VerfasserIn]
Amano, Hizuru [VerfasserIn]
Kawashima, Hiroshi [VerfasserIn]
Uchida, Hiroo [VerfasserIn]
Shirota, Chiyoe [VerfasserIn]

Links:

Volltext

Themen:

CUSUM
Cumulative sum
Journal Article
Learning curve
Performance monitoring
Thoracoscopic repair of esophageal atresia
Tracheoesophageal fistula

Anmerkungen:

Date Completed 28.11.2023

Date Revised 28.11.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s00595-023-02687-9

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM355914239