期刊
ANNALS OF SURGERY
卷 269, 期 2, 页码 221-228出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/SLA.0000000000002996
关键词
laparoscopic liver surgery; learning curve; outcomes; risk-adjusted cumulative sum analysis; training
类别
Objective: To compare the learning curves of the self-taught pioneers of laparoscopic liver surgery (LLS) with those of the trained early adopters in terms of short- and medium-term patient outcomes to establish if the learning curve can be reduced with specific training. Summary of Background Data: It is expected that a wider adoption of a laparoscopic approach to liver surgery will be seen in the next few years. Current guidelines stress the need for an incremental, stepwise progression through the learning curve in order to minimize harm to patients. Previous studies have examined the learning curve in Stage 2 of the IDEAL paradigm of surgical innovation; however, LLS is now in stage 3 with specific training being provided to surgeons. Methods: Using risk-adjusted cumulative sum analysis, the learning curves and short- and medium-term outcomes of 4 pioneering surgeons from stage 2 were compared with 4 early adapting surgeons from stage 3 who had received specific training for LLS. Results: After 46 procedures, the short- and medium-term outcomes of the early adopters were comparable to those achieved by the pioneers following 150 procedures in similar cases. Conclusions: With specific training, early adapting laparoscopic liver surgeons are able to overcome the learning curve for minor and major liver resections faster than the pioneers who were self-taught in LLS. The findings of this study are applicable to all surgical specialties and highlight the importance of specific training in the safe expansion of novel surgical practice.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据