Learning thoracoscopic lobectomy in resident training

Thorac Cardiovasc Surg. 2014 Dec;62(8):690-5. doi: 10.1055/s-0033-1364203. Epub 2014 Mar 3.

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.

MeSH terms

  • Aged
  • Clinical Competence
  • Education, Medical, Continuing / methods*
  • Female
  • Humans
  • Internship and Residency*
  • Learning Curve*
  • Male
  • Middle Aged
  • Operative Time
  • Patient Safety
  • Pneumonectomy / adverse effects
  • Pneumonectomy / education*
  • Retrospective Studies
  • Risk Factors
  • Task Performance and Analysis
  • Thoracoscopy / adverse effects
  • Thoracoscopy / education*
  • Time Factors