Study on the learning curve for thoracoscopic and laparoscopic radical resection of esophageal cancer

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BACKGROUND: The procedure for thoracoscopic and laparoscopic radical resection of esophageal cancer is complicated, so the operation time is long, which can easily negatively affect the self-confidence of young thoracic surgeons. This retrospective cohort study aimed to improve young thoracic surgeons' understanding of this type of surgery by analyzing the learning curve. METHODS: From October 2017 to August 2018, 64 patients who underwent thoracoscopic and laparoscopic radical resection of esophageal cancer by a single team were reviewed by a retrospective cohort study. These patients were divided into four groups according to the date of operation. The baseline data, operation time, the amount of bleeding during the operation, and the number of lymph nodes sampled were compared. Then, the quality of the different stages of the operation was analyzed and evaluated. RESULTS: There were no significant differences in the general baseline data, chest tube duration, or number of samples collected from the right laryngeal nodes among the four groups (p > 0.05). With the accumulation of experience, several key measures of surgical benefit were significantly different among the four groups. Specifically, the operation time became shorter, the amount of bleeding gradually decreased, the number of lymph nodes sampled gradually increased, and the number of left para-recurrent laryngeal nerve lymph nodes sampled gradually increased (p < 0.05). CONCLUSION: According to the learning curve, approximately 16 patients needed to complete this type of operation in 300 min, and 22 patients needed to be independently sampled from more than 20 lymph nodes.

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