Evidence map›Paper›PMID 39054512›Full record

ArticleBMC women's health2024

Learning curve analysis of transvaginal natural orifice transluminal endoscopic surgery in treating ovarian cysts: a retrospective cohort study.

Dan Feng, Tianjiao Liu, Xin Li, Lu Huang, Li Xiao, Li He, Yonghong Lin

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Article in BMC women's health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

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6citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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6 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Dan Feng *Department of Gynecology Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China.
Tianjiao Liu *Department of Gynecology Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China.
Xin Li *Department of Obstetrics, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.
Lu HuangDepartment of Gynecology Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China.
Li XiaoThe Medical Administration Department, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China. 250129266@qq.com.
Li HeDepartment of Gynecology Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China. helisichuan@163.com.
Yonghong LinDepartment of Gynecology Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China. linyhcd2011@163.com.

Funding

Chengdu High-level Key Clinical Specialty Construction Project, Chengdu Municipal Health Commission Project 2021215Chengdu Municipal Medical Research Project in 2023 2023352Fifth Round of Chengdu Municipal Science and Technology Research Program 2021-YF05-00627-SNJapan China Sasakawa Medical Fellowship Program 4408
6 · The paper itself

Abstract

backgroundTransvaginal Natural Orifice Transluminal Endoscopy (vNOTES) is regarded as a challenging surgical technique to learn but is promising in reducing perioperative pain and significantly improves the cosmetic outcomes. Previous studies on the learning curve analysis of vNOTES mainly focuses on the hysterectomy approach, while the vNOTES ovarian cystectomy's learning curve was merely reported though more frequently performed than vNOTES hysterectomy. Therefore, this study seeks to analyze the learning curve of three surgeons with varying levels of experience in performing endoscopic surgery and vaginal surgeries for the treatment of ovarian cysts using vNOTES.

methodsA total of 127 patients with ovarian cysts of a variety of pathological types were treated by ovarian vNOTES performed by three surgeons of different levels of endoscopic and transvaginal surgical experience. Each surgeon's learning curve was plotted using the Cumulative Sum method and divided into three or four phases of technique learning at the turning point of the learning curve. The sociodemographic and clinical features of patients in each phase were then compared and factors potentially associated with operation time were also screened.

resultsThe learning curve was presented in four phases. The operation time (OT) was significantly shorter in phases II (53.66 ± 16.55 min) and IV (54.39 ± 23.45 min) as compared with phases I (68.74 ± 15.85) and III (75.93 ± 30.55) (p < 0.001). More cases of serve pelvic adhesion and endometrioma were assigned in the later phases. The OT of endometriotic cysts had much longer than that of non-endometriotic cysts(62.57 ± 18.64 min vs. 49.88 ± 14.26 min, p = 0.15) The presence of pelvic adhesion [adjusted odds ratio (OR) 7.149 (0.506, 13.792), p = 0.035] and bilateral cyst [adjusted OR 16.996 (2.155, 31.837), p = 0.025], max diameter of cyst[adjusted OR 2.799 (0.174, 5.425), p = 0.037], and individual surgeon [adjusted OR -6.118 (-11.814, -0.423), p = 0.035] were significantly associated with OT.

conclusionThere learning curve of ovarian vNOTES has four phases. ovarian vNOTES could be mastered after performing seven, nine, and 16 cases by surgeons #1, 2 and 3 respectively, in gynecologic endoscopic surgeries.

trial registrationChiCTR2200059282 (Registered on April 28th, 2022).

Indexed as

Learning CurveNatural Orifice Endoscopic SurgeryOperative TimeOvarian CystsAdultClinical CompetenceCohort StudiesFemaleHumansMiddle AgedRetrospective StudiesVaginaCumulative sum analysisLearning curveOvarian cystectomyTransvaginal natural orifice transluminal endoscopic surgery

Identifiers

PMID39054512
PMCPMC11270853

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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.