ArticleClinical and experimental otorhinolaryngology2022
Cumulative Sum Analysis of the Learning Curve of Free Flap Reconstruction in Head and Neck Cancer Patients.
Article in Clinical and experimental otorhinolaryngology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed.
- Learning Curve and Technical Strategies in 100 Consecutive Head and Neck Free-Flap Reconstructions by an Early-Career Plastic Surgeon.Journal of plastic and reconstructive surgery · 2026Article
- Does "the More, the Merrier" Apply to the Free Flap Learning Curve? A Ten-Year Retrospective Review from an Emerging Single Institution.Plastic surgery (Oakville, Ont.) · 2026Article
- Vein-protection-first strategy revolutionizes submental artery perforator flap harvest success: the A-B-C technique and training assessment.BMC oral health · 2026Article
- Robotic-assisted optical navigation system for CT-guided preoperative percutaneous Hook-wire localization of pulmonary nodules: a prospective, single-center, single-arm clinical study.World journal of surgical oncology · 2026Article
- Integrating microsurgical reconstruction in head and neck oncology: a collaborative learning curve experience.Medicine and pharmacy reports · 2026Article
- Evaluating the Efficacy and Complications of the Scapular Osseous Free Flap for Head and Neck Reconstruction: Results from a Population-based Cohort.JPRAS open · 2024Article
- Effect of segmental versus marginal mandibular resection on local and lymph node recurrences in oral squamous cell carcinoma: is tumorous bone infiltration or location and resulting soft tissue recurrences a long-term problem?Journal of cancer research and clinical oncology · 2023Article
- Superficial Temporal Artery and Vein as Alternative Recipient Vessels for Intraoral Reconstruction With Free Flaps to Avoid the Cervical Approach With the Resulting Need for Double Flap Transfer in Previously Treated Necks.Frontiers in oncology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesOwing to the functional and structural complexity of the head and neck area, the reconstruction of defects in these areas is challenging. Free flap surgery has become standard for the reconstruction of the head and neck with improvements in microvascular surgery. The aim of this study was to use the cumulative sum (CUSUM) method to evaluate the learning curve for free-flap head and neck reconstruction performed by a single surgeon.
methodsWe retrospectively reviewed the medical records of 47 patients who underwent free-flap reconstruction from 2017 to 2021. The clinical demographics and surgical outcomes were analyzed. The total operation time was analyzed using the CUSUM method, which is an analytical approach for visualizing patterns in data by converting raw data into an accumulation of deviations from the average value.
resultsCUSUM analysis showed two phases of the learning curve: phase 1 (cases 1-22) and phase 2 (cases 23-47). The operative time in phase 1 (579.9±128.2 minutes) was significantly longer than that in phase 2 (418.6±80.9 minutes) (P<0.001). The re-exploration rate was higher in phase 1 (31.8%) than in phase 1 (4%) (P=0.018). The flap failure rate was higher in phase 1 (9.1%) than in phase 1 (4%), but this difference was not statistically significant (P=0.593).
conclusionThe learning curve of free-flap head and neck reconstruction seems to stabilize after approximately 20 cases.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.