Version 1
: Received: 6 November 2024 / Approved: 7 November 2024 / Online: 7 November 2024 (03:24:17 CET)
How to cite:
Pages, P. B.; Cottenet, J.; Madelaine, L.; Dhérissard, F.; Abou-Hanna, H.; Bernard, A.; Quantin, C. Evaluation of the Learning Curve Threshold in Robot-Assisted Thoracic Surgery for Lung Cancer: A Nationwide Population-Based Study. Preprints2024, 2024110491. https://doi.org/10.20944/preprints202411.0491.v1
Pages, P. B.; Cottenet, J.; Madelaine, L.; Dhérissard, F.; Abou-Hanna, H.; Bernard, A.; Quantin, C. Evaluation of the Learning Curve Threshold in Robot-Assisted Thoracic Surgery for Lung Cancer: A Nationwide Population-Based Study. Preprints 2024, 2024110491. https://doi.org/10.20944/preprints202411.0491.v1
Pages, P. B.; Cottenet, J.; Madelaine, L.; Dhérissard, F.; Abou-Hanna, H.; Bernard, A.; Quantin, C. Evaluation of the Learning Curve Threshold in Robot-Assisted Thoracic Surgery for Lung Cancer: A Nationwide Population-Based Study. Preprints2024, 2024110491. https://doi.org/10.20944/preprints202411.0491.v1
APA Style
Pages, P. B., Cottenet, J., Madelaine, L., Dhérissard, F., Abou-Hanna, H., Bernard, A., & Quantin, C. (2024). Evaluation of the Learning Curve Threshold in Robot-Assisted Thoracic Surgery for Lung Cancer: A Nationwide Population-Based Study. Preprints. https://doi.org/10.20944/preprints202411.0491.v1
Chicago/Turabian Style
Pages, P. B., Alain Bernard and Catherine Quantin. 2024 "Evaluation of the Learning Curve Threshold in Robot-Assisted Thoracic Surgery for Lung Cancer: A Nationwide Population-Based Study" Preprints. https://doi.org/10.20944/preprints202411.0491.v1
Abstract
Background: Recent publications suggest that the threshold for validation of the learning curve is 25 procedures. The aim of this study was to evaluate this threshold using another method which is little used, based on a composite quality indicator. Methods: We included all patients from the French medico-administrative database receiving robot-assisted surgery for lung cancer between 2019 and 2022 in hospitals performing at least 25 procedures. For postoperative complications analysis we used the Clavien-Dindo classification. We used the sequential probability ratio test to estimate the number of procedures from which a team achieved its learning curve. Results: In France, the number of robotic-assisted procedures has risen steadily over the years: 195 in 2019 and 1,567 in 2022: overall, 28 teams performed 3,707 Robot-Assisted surgery for lung cancer. The total number of patients with Clavien-dindo classification > II was 833 (24.7%). Among the 28 hospitals, 8 achieved their learning curve with a threshold ranging from 94 to 174 procedures, and a median of 110. Severe complications such as acute respiratory distress syndrome, respira-tory failure, heart failure, acute ischemia of the lower limbs and pulmonary embolism were signif-icantly more frequent in the group of hospitals that did not validate the learning curve threshold. Conclusion: This study suggests that the threshold of 25 procedures may not be sufficient enough to validate the robot-assisted surgery learning curve in lung cancer surgery. To significantly re-duce postoperative complications, a team would need to perform between 94 to 174 procedures to guarantee patient safety.
Medicine and Pharmacology, Pulmonary and Respiratory Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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