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Learning Curve for Thoracoscopic Individual Basilar Segmentectomy: 18-Year Experience

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Abstract

Background

Thoracoscopic anatomical individual basilar segmentectomy remains challenging owing to the deep intraparenchymal location of the hilar structures and anatomical variations. We analyzed and reported the experience and progress of thoracoscopic anatomical individual basilar segmentectomy at our university hospital.

Methods

We retrospectively examined the patients who underwent anatomical basilar segmentectomy at our institution from January 2004 to December 2021. We divided our analysis period into two parts: the first period (2004–2012) was the introductory period of video-assisted thoracoscopic surgery (VATS) segmentectomy, and the second period (2013–2021) was the maturity period of VATS segmentectomy. The learning curve of the leading surgeon in the second period was also evaluated based on the operative time and cumulative sum value of the operative time.

Results

Overall, 127 cases were evaluated, among whom 33 and 94 cases were assessed during the introductory and maturity periods of thoracoscopic segmentectomy, respectively. Age (P = 0.003) and Charlson comorbidity index (P = 0.002) were higher in the second period than in the first period. Use of a uniport (P = 0.006) was higher, and postoperative hospitalization duration (P =  < 0.001) and operative time (P = 0.024) were shorter in the second period than in the first period. A learning curve obtained during the maturity period showed: The inflection point for the learning curve of thoracoscopic basilar segmentectomy was reached after 42 cases.

Conclusions

We have demonstrated a single institution’s progress and learning curve for difficult segmentectomies. This may be helpful to institutions considering performing this surgery.

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Acknowledgements

We thank Editage (www.editage.jp) for English language editing.

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Authors and Affiliations

  1. Department of Surgery II, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan

    Satoshi Takamori, Hiroyuki Oizumi, Jun Suzuki, Hikaru Watanabe, Kaito Sato & Satoshi Shiono

  2. Department of General Thoracic Surgery, Yamagata Prefectural Central Hospital, 1800, Oazaaoyagi, Yamagata, 990-2292, Japan

    Satoshi Takamori

  3. Department of General Thoracic Surgery, Higashiyamato Hospital, 1-13-12 Nangai, Higashiyamato, Tokyo, 207-0014, Japan

    Hiroyuki Oizumi

  4. Department of Public Health and Hygiene, Yamagata University Graduate School of Medical Science, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan

    Ri Sho

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  1. Satoshi Takamori
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  2. Hiroyuki Oizumi
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  3. Jun Suzuki
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Correspondence to Satoshi Takamori.

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The authors declare that they have no known conflict of interest.

Ethical approval

This study was approved by the ethics committee of the Faculty of Medicine, Yamagata University (approval number 2021-386; dated March 31, 2022). The requirement for informed consent was waived owing to the retrospective nature of the study.

Informed consent

In the present study, the participants were given the option to opt out online. None of the patients declined to participate.

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Takamori, S., Oizumi, H., Suzuki, J. et al. Learning Curve for Thoracoscopic Individual Basilar Segmentectomy: 18-Year Experience. World J Surg 47, 2917–2924 (2023). https://doi.org/10.1007/s00268-023-07162-7

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