ArticleInteractive cardiovascular and thoracic surgery2022
Learning curve of uniportal video-assisted thoracoscopic lobectomy: an analysis of the proficiency of 538 cases from a single centre.
Article in Interactive cardiovascular and thoracic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Safe introduction of uniportal video-assisted thoracoscopic surgery in an academic center: the learning process and training implications.Surgery today · 2026Article
- Clinical benefits of the 5th intercostal incision in uniportal VATS for female patients.Scientific reports · 2025Article
- Learning curve for double micro-portal video-assisted thoracoscopic lobectomy.Journal of thoracic disease · 2025Article
- Article
- Uniportal video-assisted thoracoscopic surgery for lobectomy: the learning curve.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Supervision by an experienced surgeon can reduce the learning curve of uniportal thoracoscopic lobectomy.Translational lung cancer research · 2023Article
- The learning curve of endoscopic endonasal transsphenoidal surgery for pituitary adenomas with different surgical complexity.Frontiers in surgery · 2023Article
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Authors and funding
12 authors.
Funding
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Abstract
objectivesUniportal video-assisted thoracoscopic surgery (UniVATS) is widely used as a minimally invasive thoracic operation. The goal of our study was to analyse the effect of long-term experience with the UniVATS lobectomy on the learning curve.
methodsThe learning curves were quantitatively evaluated by the unadjusted cumulative sum, and they were segmented using joinpoint linear regression analysis. The variables were compared between subgroups using trend analysis, and linear regression analysis was applied to correlate clinical characteristics at different stages of the learning curve with the duration of the operation.
resultsThe learning curve for the UniVATS lobectomy can be divided into 3 phases of proficiency at ∼200-300 procedures, with a fourth phase as the number of procedures increases. The 1st-52nd, 52nd-156th, 156th-244th and 244th-538th procedures comprised the preliminary learning stage, preliminary proficiency stage, proficiency stage and advanced proficiency stage, respectively. Surgical outcomes and their variability between stages improved with increasing case numbers, with the most significant addition of an auxiliary operating port and conversions. In multivariable analysis, as stages progressed, influences other than surgical experience increased the operative time, with male and extensive pleural adhesions in the preliminary proficiency stage; male and incomplete pulmonary fissures in the proficiency stage; and male, extensive pleural adhesions and incomplete pulmonary fissures in the advanced proficiency stage.
conclusionsAs the number of procedures increases, there may be 4 different proficiency stages in the UniVATS lobectomy learning curve. The surgeon enters the fourth stage at approximately the 244th procedure. Moreover, at stage 4, the perioperative indicators tend to stabilize, and influences other than surgical experience become more significant.
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