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Learning Curves of Ivor Lewis Totally Minimally Invasive Esophagectomy by Hospital and Surgeon Characteristics: A Retrospective Multinational Cohort Study
- Source :
- Annals of surgery, 275(5), 911-918. Lippincott Williams and Wilkins, Claassen, L, Hannink, G, Luyer, M D P, Ainsworth, A P, Henegouwen, M I V B, Cheong, E, Daams, F, van Det, M J, van Duijvendijk, P, Gisbertz, S S, Gutschow, C A, Heisterkamp, J, Kauppi, J T, Klarenbeek, B R, Kouwenhoven, E A, Langenhoff, B S, Larsen, M H, Martijnse, I S, Nieuwenhoven, E J V, van der Peet, D L, Pierie, J-P E N, Pierik, R E G J M, Polat, F, Rusanen, J V, Rouvelas, I, Sosef, M N, Wassenaar, E B, Wildenberg, F J H V D, van der Zaag, E S, Nilsson, M, Nieuwenhuijzen, G A P, van Workum, F, Rosman, C & Esophagectomy Learning Curve Collaborative Group 2022, ' Learning Curves of Ivor Lewis Totally Minimally Invasive Esophagectomy by Hospital and Surgeon Characteristics : A Retrospective Multinational Cohort Study ', Annals of Surgery, vol. 275, no. 5, pp. 911-918 . https://doi.org/10.1097/SLA.0000000000004801, Annals of Surgery, 275, 911-918, Annals of Surgery, 275, 5, pp. 911-918
- Publication Year :
- 2022
-
Abstract
- OBJECTIVE: To describe the pooled learning curves of Ivor Lewis totally minimally invasive esophagectomy (TMIE) in hospitals stratified by predefined hospital- and surgeon-related factors.BACKGROUND: Ivor Lewis (TMIE is known to have a long learning curve which is associated with considerable learning associated morbidity. It is unknown whether hospital and surgeon characteristics are associated with more efficient learning.METHODS: A retrospective analysis of prospectively collected data of consecutive Ivor Lewis TMIE patients in 14 European hospitals was performed. Outcome parameters used as proxy for efficient learning were learning curve length, learning associated morbidity, and the plateau level regarding anastomotic leakage and textbook outcome. Pooled incidences were plotted for the factor-based subgroups using generalized additive models and 2-phase models. Casemix predicted outcomes were plotted and compared with observed outcomes. The investigated factors included annual volume, TMIE experience, clinic visits, courses and fellowships followed, and proctor supervision.RESULTS: This study included 2121 patients. The length of the learning curve was shorter for centers with an annual volume >50 compared to centers with an annual volume CONCLUSIONS: More efficient learning was observed in centers with higher annual volume. Visiting an expert clinic, completing a fellowship, or implementation under a proctor's supervision were not associated with more efficient learning.
- Subjects :
- Postoperative Complications/epidemiology
medicine.medical_specialty
Minimally Invasive Surgical Procedures/methods
Esophageal Neoplasms
education
MEDLINE
Laparoscopy/methods
Cohort Studies
Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]
All institutes and research themes of the Radboud University Medical Center
Postoperative Complications
Invasive esophagectomy
medicine
Humans
Minimally Invasive Surgical Procedures
Ivor lewis
efficient learning
Ivor Lewis totally minimally invasive esophagectomy
Retrospective Studies
Surgeons
Esophageal Neoplasms/complications
business.industry
General surgery
Esophagectomy/methods
Hospitals
Outcome parameter
Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10]
Esophagectomy
Treatment Outcome
Multi national
Learning curve
Anastomotic leakage
learning curves
Laparoscopy
Surgery
business
Learning Curve
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 00034932
- Database :
- OpenAIRE
- Journal :
- Annals of surgery, 275(5), 911-918. Lippincott Williams and Wilkins, Claassen, L, Hannink, G, Luyer, M D P, Ainsworth, A P, Henegouwen, M I V B, Cheong, E, Daams, F, van Det, M J, van Duijvendijk, P, Gisbertz, S S, Gutschow, C A, Heisterkamp, J, Kauppi, J T, Klarenbeek, B R, Kouwenhoven, E A, Langenhoff, B S, Larsen, M H, Martijnse, I S, Nieuwenhoven, E J V, van der Peet, D L, Pierie, J-P E N, Pierik, R E G J M, Polat, F, Rusanen, J V, Rouvelas, I, Sosef, M N, Wassenaar, E B, Wildenberg, F J H V D, van der Zaag, E S, Nilsson, M, Nieuwenhuijzen, G A P, van Workum, F, Rosman, C & Esophagectomy Learning Curve Collaborative Group 2022, ' Learning Curves of Ivor Lewis Totally Minimally Invasive Esophagectomy by Hospital and Surgeon Characteristics : A Retrospective Multinational Cohort Study ', Annals of Surgery, vol. 275, no. 5, pp. 911-918 . https://doi.org/10.1097/SLA.0000000000004801, Annals of Surgery, 275, 911-918, Annals of Surgery, 275, 5, pp. 911-918
- Accession number :
- edsair.doi.dedup.....a0e30cded2cc2b9a5161855d2e16588e