ArticleSurgery today2024
Learning process analysis of robotic lateral pelvic lymph node dissection for local advanced rectal cancer: the CUSUM curve of 78 consecutive patients.
Article in Surgery today, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Learning curve for lateral lymph node dissection in rectal cancer - a systematic review of literature.Techniques in coloproctology · 2025Pooled it
- Initial adaptation to robotic rectal cancer surgery using the hinotori surgical robot system: a CUSUM analysis of certified proctor surgeons.Journal of robotic surgery · 2026Article
- Robotic colorectal surgery: making sense of the learning curve.Journal of robotic surgery · 2026Review
- Evaluation of Short-Term Postoperative Outcomes of Lateral Lymph Node Dissection After Neoadjuvant Radiotherapy for Rectal Cancer Patients: The Early Learning Phase After Surgical Training in the Netherlands.Annals of surgical oncology · 2025Article
- Learning curve analysis for prophylactic bilateral robot-assisted lateral lymph node dissection for lower rectal cancer: a retrospective study.Techniques in coloproctology · 2025Article
- Analysis of factors influencing optimal humeral-sided reconstruction in anatomic total shoulder arthroplasty.JSES international · 2025Article
- The Learning Curve of Reverse-Sequence Endoscopic Nipple-Sparing Mastectomy with Immediate Prepectoral Implant Reconstruction: CUSUM Analysis.Breast cancer (Dove Medical Press) · 2025Article
- Robot-assisted laparoscopic hepatectomy for hepatocellular carcinoma with Fontan-associated liver disease: a world-first case report.Surgical case reports · 2024Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRobotic lateral lymph node dissection (LLND) has been described as a safe and feasible procedure for local advanced rectal cancer. The aim of this study was to evaluate the learning curve for robotic-assisted LLND.
methodsWe collected data on 78 consecutive patients who underwent robotic-LLND at our hospital. The learning curve was analyzed using the cumulative sum (CUSUM) method to assess changes in the unilateral LLND operative times across the case sequence.
resultsAmong the 78 patients, 52 underwent bilateral LLND and 26 underwent unilateral LLND. A total of 130 consecutive data were recorded. We arranged unilateral robotic-LLND operative times and calculated cumulative sum values, allowing the differentiation of three phases: phase I (learning period, cases 1-51); phase II (proficiency period, cases 52-83); and phase III (mastery period, cases 84-130). As the learning curve accumulated, the operation time and estimated blood loss of unilateral robotic-LLND decreased significantly with each phase (P < 0.05). By 12 months after surgery, the International Prostatic Symptom Score of patients at phase III was significantly lower than at phase I (P < 0.05).
conclusionThe CUSUM curve shows three phases in the learning of robotic-LLND. The estimated learning curve for robotic-assisted rectal-LLND is achieved after 51 cases.
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