Learning Curve of Single Pore Video-assisted Thoracoscopic Surgery for the Treatment of Pulmonary Bullae_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WUZheng-guo ¹ , NONGWen-gui ¹ ,  TAOHong-fa ¹ , ZHANGChao ¹ , CAOQing-dong ²

1. Department of Thoracic and Cardiovascular Surgery, Songgang People's Hospital, Shenzhen 518105, Guangdong, P. R. China;
2. Department of Thoracic and Cardiovascular Surgery, Baoan People's Hospital, Shenzhen 518100, Guangdong, P. R. China;

Corresponding author：

TAOHong-fa, Email: gmzgjl@163.com

Keywords：

Single pore video-assisted thoracoscopic surgery; Pulmonary bulla; Learning curve

DOI：

10.7507/1007-4848.20140144

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To explore the learning curve of single pore video-assisted thoracoscopic surgery (VATS) for the treatment of pulmonary bullae. Methods From July 2010 to October 2011, sixty consecutive patients with pulmo-nary bulla undergoing single pore VATS by the same group of surgeons in the Department of Thoracic and Cardiovascular Surgery, Songgang People's Hospital. According to the sequence of the operations, all the patients were divided into group A, B, and C with 20 patients in each group. Operation time, intraoperative blood loss, postoperative hospital stay and thoracic drainage duration were compared between the 3 groups to evaluate surgical outcomes in different stages. Operation time and postoperative hospital stay were the main indexes of the learning curve. Results There was no statistical difference in age, gender or incidence of pneumothorax between the 3 groups (P > 0.05). Operation time of group A (42.7±9.4 minutes) was significantly longer than those of group B (21.3±6.7 minutes) and group C (20.8±7.5 minutes) (P < 0.01). Postoperative hospital stay of group A (10.6±2.2 days) was significantly longer than those of group B (7.6±1.2 days) and group C (7.4±1.2 days) (P < 0.05). There was no statistical difference in other indexes among the 3 groups (P > 0.05). Conclusion The learning curve of single pore VATS for the treatment of pulmonary bullae is approximately 20 cases.

Citation： WUZheng-guo, NONGWen-gui, TAOHong-fa, ZHANGChao, CAOQing-dong. Learning Curve of Single Pore Video-assisted Thoracoscopic Surgery for the Treatment of Pulmonary Bullae. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(4): 511-514. doi: 10.7507/1007-4848.20140144 Copy

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2.	Salati M, Brunelli A, Xiumè F, et al. Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax:clinical and economic analysis in comparison to the traditional approach. Interac Cardiovasc Thorac Surg, 2008, 7 (1):63-66.
3.	Jutley RS, Khalil MW, Rocco G. Uniportal vs standard three-port VATS technique for spontaneous pneumothorax:comparison of post operative pain and residual paraesthesia. Eur J Cardiothorac Surg, 2005, 28 (1):43-46.
4.	Gigirey Castro O, Berlanga González L, Sánchez Gómez E. Single port thorascopic surgery using the SILS tool as a novel method in the surgical treatment of pneumothorax. Arch Bronconeumol, 2010, 46(8):439-441.
5.	Chen PR, Chen CK, Lin YS, et al. Single-incision thoracoscopic surgery for primary spontaneous pneumothorax. J Cardiothorac Surg, 2011, 6:58.
6.	Ng CS, Wan S, Yim AP. Paradigm shift in surgical approaches to spontaneous pneu-mothorax:VATS.Thorax, 2004, 59 (4):357.
7.	朱晓枫, 范军, 马东春, 等.电视胸腔镜手术治疗自发性气胸.中国微创外科杂志, 2008, 8 (7):611-612.
8.	Nguyen NT, FoUete DM, Wolfe BM, et al. Comparison of minimally invasive esophagectomy with transthoracic and transhiatal esophagectomy. Arch Surg, 2000, 135 (8):920-925.
9.	Palanivelu C, Prakash A, Senthilkumar R, et al. Minimally invasive esophagectomy:thoracoscopie mobilization of the esophagus and mediastinal lymphadenectomy in prone position experience of 130 patients. J Am Coll Surg, 2006, 203 (1):7-16.
10.	Berlanga LA, Gigirey O. Uniportal video-assisted thoracic surgery forprimary spontaneous pneumothorax using a single-incision laparoscopic surgeryport:a feasible and safe procedure. Surg Endosc, 2011, 25 (6):2044-2047.
11.	曹庆东, 高雪峰, 李晓剑, 等.单孔胸腔镜手术的临床应用.中华胸心血管外科杂志, 2011, 9 (27):546-548.
12.	车国卫, 梅龙勇, 梅建东, 等.单操作孔电视胸腔镜手术治疗肺部疾病158例临床分析.中国胸心血管外科临床杂志, 2012, 19 (2):116-119.
13.	车国卫, 刘伦旭.单孔电视胸腔镜手术临床应用的现状与进展.中国胸心血管外科临床杂志, 2012, 19 (2):181-184.
14.	初向阳, 薛志强, 刘毅, 等.单操作孔电视胸腔镜肺叶切除术治疗早期肺癌的临床研究.中国胸心血管外科临床杂志, 2012, 19 (2):113-115.
15.	许建功, 蔡瑞君, 王禹冰, 等.胸腔镜联合腹腔镜食管癌根治术学习曲线研究.中国全科医学杂志, 2012, 15 (6):631-634.
16.	吴伟彬, 黄邵洪, 张健, 等.胸腔镜下交感神经切除术治疗手汗症的学习曲线.新医学, 2012, 43 (7):473-475.
17.	刘晟, 仇明, 汪道振, 等.微创手术学习曲线的新概念与临床意义中国微创外科杂志, 2008, 8 (1):5-6.
18.	Zhao H, Bu L, Yang F, et al. Video-assisted thoracoscopic surgery lobectomy for lung cancer:the learning curve. World J Surg, 2010, 34 (10):2368-2372.
19.	Melfi FM, Mussi A. Robotically assisted lobectomy:learning curve and complications. Thorae Surg Clin, 2008, 18 (3):289-295.
20.	赵辉, 王俊, 刘军, 等.胸腔镜肺叶切除术治疗早期肺癌的学习曲线.中华胸心血管外科杂志, 2009, 25 (1):23-25.
21.	Osugi H, Takemura M, Higashino M, et al. Learning curve of video-assisted thoracoseopie esophagectomy and extensive lymphadenectomy for squamous cell cancer of the thoracic esophagus and results. Surg Endosc, 2003, 17 (3):515-519.

1. Vodicka J. Are there any news in the management of spontaneous pneumothorax? Rozhl Chir, 2011, 90 (11):625-630.
2. Salati M, Brunelli A, Xiumè F, et al. Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax:clinical and economic analysis in comparison to the traditional approach. Interac Cardiovasc Thorac Surg, 2008, 7 (1):63-66.
3. Jutley RS, Khalil MW, Rocco G. Uniportal vs standard three-port VATS technique for spontaneous pneumothorax:comparison of post operative pain and residual paraesthesia. Eur J Cardiothorac Surg, 2005, 28 (1):43-46.
4. Gigirey Castro O, Berlanga González L, Sánchez Gómez E. Single port thorascopic surgery using the SILS tool as a novel method in the surgical treatment of pneumothorax. Arch Bronconeumol, 2010, 46(8):439-441.
5. Chen PR, Chen CK, Lin YS, et al. Single-incision thoracoscopic surgery for primary spontaneous pneumothorax. J Cardiothorac Surg, 2011, 6:58.
6. Ng CS, Wan S, Yim AP. Paradigm shift in surgical approaches to spontaneous pneu-mothorax:VATS.Thorax, 2004, 59 (4):357.
7. 朱晓枫, 范军, 马东春, 等.电视胸腔镜手术治疗自发性气胸.中国微创外科杂志, 2008, 8 (7):611-612.
8. Nguyen NT, FoUete DM, Wolfe BM, et al. Comparison of minimally invasive esophagectomy with transthoracic and transhiatal esophagectomy. Arch Surg, 2000, 135 (8):920-925.
9. Palanivelu C, Prakash A, Senthilkumar R, et al. Minimally invasive esophagectomy:thoracoscopie mobilization of the esophagus and mediastinal lymphadenectomy in prone position experience of 130 patients. J Am Coll Surg, 2006, 203 (1):7-16.
10. Berlanga LA, Gigirey O. Uniportal video-assisted thoracic surgery forprimary spontaneous pneumothorax using a single-incision laparoscopic surgeryport:a feasible and safe procedure. Surg Endosc, 2011, 25 (6):2044-2047.
11. 曹庆东, 高雪峰, 李晓剑, 等.单孔胸腔镜手术的临床应用.中华胸心血管外科杂志, 2011, 9 (27):546-548.
12. 车国卫, 梅龙勇, 梅建东, 等.单操作孔电视胸腔镜手术治疗肺部疾病158例临床分析.中国胸心血管外科临床杂志, 2012, 19 (2):116-119.
13. 车国卫, 刘伦旭.单孔电视胸腔镜手术临床应用的现状与进展.中国胸心血管外科临床杂志, 2012, 19 (2):181-184.
14. 初向阳, 薛志强, 刘毅, 等.单操作孔电视胸腔镜肺叶切除术治疗早期肺癌的临床研究.中国胸心血管外科临床杂志, 2012, 19 (2):113-115.
15. 许建功, 蔡瑞君, 王禹冰, 等.胸腔镜联合腹腔镜食管癌根治术学习曲线研究.中国全科医学杂志, 2012, 15 (6):631-634.
16. 吴伟彬, 黄邵洪, 张健, 等.胸腔镜下交感神经切除术治疗手汗症的学习曲线.新医学, 2012, 43 (7):473-475.
17. 刘晟, 仇明, 汪道振, 等.微创手术学习曲线的新概念与临床意义中国微创外科杂志, 2008, 8 (1):5-6.
18. Zhao H, Bu L, Yang F, et al. Video-assisted thoracoscopic surgery lobectomy for lung cancer:the learning curve. World J Surg, 2010, 34 (10):2368-2372.
19. Melfi FM, Mussi A. Robotically assisted lobectomy:learning curve and complications. Thorae Surg Clin, 2008, 18 (3):289-295.
20. 赵辉, 王俊, 刘军, 等.胸腔镜肺叶切除术治疗早期肺癌的学习曲线.中华胸心血管外科杂志, 2009, 25 (1):23-25.
21. Osugi H, Takemura M, Higashino M, et al. Learning curve of video-assisted thoracoseopie esophagectomy and extensive lymphadenectomy for squamous cell cancer of the thoracic esophagus and results. Surg Endosc, 2003, 17 (3):515-519.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Learning Curve of Single Pore Video-assisted Thoracoscopic Surgery for the Treatment of Pulmonary Bullae

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