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DOI: 10.1055/s-0033-1364203
Learning Thoracoscopic Lobectomy in Resident Training
Publication History
28 September 2013
22 November 2013
Publication Date:
03 March 2014 (online)
![](https://www.thieme-connect.de/media/thoracic/201408/lookinside/thumbnails/10.1055-s-0033-1364203-1.jpg)
Abstract
Background Thoracoscopic lobectomy is a safe and effective procedure; however, the ways by which to incorporate this technically demanding procedure into residency training is still unknown. We reported on the outcomes of thoracoscopic lobectomies performed by a single thoracic resident, who was simultaneously undergoing training for both open and thoracoscopic lobectomies.
Patients and Methods Between January 2010, and May 2011, data from 87 consecutive thoracoscopic lobectomies that were performed by a trainee surgeon (B.-Y.W.) were prospectively obtained. Data were grouped into the first 30 and subsequent 57 cases. Patient characteristics, operative data, complications, and surgical pathology were analyzed.
Results The mean operating time in group 2 was significantly lower compared with group 1 (264.0 ± 45.9 min in group 1 vs. 197.5 ± 57.7 min in group 2; p < 0.001). There were no mortalities in both the groups and no significant differences in postoperative complications.
Conclusions Thoracoscopic lobectomy can be taught to a nonexperienced thoracic resident during an open procedure without compromising the safety of patients. It appears that surgical performance reaches a plateau after the completion of 30 cases.
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References
- 1 Roviaro G, Rebuffat C, Varoli F, Vergani C, Mariani C, Maciocco M. Videoendoscopic pulmonary lobectomy for cancer. Surg Laparosc Endosc 1992; 2 (3) 244-247
- 2 McKenna Jr RJ, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg 2006; 81 (2) 421-425 , discussion 425–426
- 3 Onaitis MW, Petersen RP, Balderson SS , et al. Thoracoscopic lobectomy is a safe and versatile procedure: experience with 500 consecutive patients. Ann Surg 2006; 244 (3) 420-425
- 4 Nagahiro I, Andou A, Aoe M, Sano Y, Date H, Shimizu N. Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure. Ann Thorac Surg 2001; 72 (2) 362-365
- 5 Whitson BA, Groth SS, Duval SJ, Swanson SJ, Maddaus MA. Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg 2008; 86 (6) 2008-2016 , discussion 2016–2018
- 6 Ng T, Ryder BA. Evolution to video-assisted thoracic surgery lobectomy after training: initial results of the first 30 patients. J Am Coll Surg 2006; 203 (4) 551-557
- 7 Reed MF, Lucia MW, Starnes SL, Merrill WH, Howington JA. Thoracoscopic lobectomy: introduction of a new technique into a thoracic surgery training program. J Thorac Cardiovasc Surg 2008; 136 (2) 376-381
- 8 Wan IY, Thung KH, Hsin MK, Underwood MJ, Yim AP. Video-assisted thoracic surgery major lung resection can be safely taught to trainees. Ann Thorac Surg 2008; 85 (2) 416-419
- 9 Ferguson J, Walker W. Developing a VATS lobectomy programme—can VATS lobectomy be taught?. Eur J Cardiothorac Surg 2006; 29 (5) 806-809
- 10 Petersen RH, Hansen HJ. Learning thoracoscopic lobectomy. Eur J Cardiothorac Surg 2010; 37 (3) 516-520
- 11 Seder CW, Hanna K, Lucia V , et al. The safe transition from open to thoracoscopic lobectomy: a 5-year experience. Ann Thorac Surg 2009; 88 (1) 216-225 , discussion 225–226
- 12 Solomon B, Bizekis C, Dellis SL , et al. Simulating video-assisted thoracoscopic lobectomy: a virtual reality cognitive task simulation. J Thorac Cardiovasc Surg 2011; 141 (1) 249-255