Darren Chua1, Nicholas Syn1,2, Ye-Xin Koh1, Brian K P Goh1,3. 1. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore. 2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 3. Duke-National University of Singapore (NUS) Medical School, Singapore.
Abstract
BACKGROUND: Minimally invasive hepatectomy (MIH) has become an important option for the treatment of various liver tumours. A major concern is the learning curve required. The aim of this study was to perform a systematic review and summarize current literature analysing the learning curve for MIH. METHODS: A systematic review of the literature pertaining to learning curves in MIH to July 2019 was performed using PubMed and Scopus databases. All original full-text articles published in English relating to learning curves for both laparoscopic liver resection (LLR), robotic liver resection (RLR), or a combination of these, were included. To explore quantitatively the learning curve for MIH, a meta-regression analysis was performed. RESULTS: Forty studies relating to learning curves in MIH were included. The median overall number of procedures required in studies utilizing cumulative summative (CUSUM) methodology for LLR was 50 (range 25-58) and for RLR was 25 (16-50). After adjustment for year of adoption of MIH, the CUSUM-derived caseload to surmount the learning curve for RLR was 47.1 (95 per cent c.i. 1.2 to 71.6) per cent; P = 0.046) less than that required for LLR. A year-on-year reduction in the number of procedures needed for MIH was observed, commencing at 48.3 cases in 1995 and decreasing to 23.8 cases in 2015. CONCLUSION: The overall learning curve for MIH decreased steadily over time, and appeared less steep for RLR compared with LLR.
BACKGROUND: Minimally invasive hepatectomy (MIH) has become an important option for the treatment of various liver tumours. A major concern is the learning curve required. The aim of this study was to perform a systematic review and summarize current literature analysing the learning curve for MIH. METHODS: A systematic review of the literature pertaining to learning curves in MIH to July 2019 was performed using PubMed and Scopus databases. All original full-text articles published in English relating to learning curves for both laparoscopic liver resection (LLR), robotic liver resection (RLR), or a combination of these, were included. To explore quantitatively the learning curve for MIH, a meta-regression analysis was performed. RESULTS: Forty studies relating to learning curves in MIH were included. The median overall number of procedures required in studies utilizing cumulative summative (CUSUM) methodology for LLR was 50 (range 25-58) and for RLR was 25 (16-50). After adjustment for year of adoption of MIH, the CUSUM-derived caseload to surmount the learning curve for RLR was 47.1 (95 per cent c.i. 1.2 to 71.6) per cent; P = 0.046) less than that required for LLR. A year-on-year reduction in the number of procedures needed for MIH was observed, commencing at 48.3 cases in 1995 and decreasing to 23.8 cases in 2015. CONCLUSION: The overall learning curve for MIH decreased steadily over time, and appeared less steep for RLR compared with LLR.
Authors: Hye Yeon Yang; Gi Hong Choi; Ken-Min Chin; Sung Hoon Choi; Nicholas L Syn; Tan-To Cheung; Adrian K H Chiow; Iswanto Sucandy; Marco V Marino; Mikel Prieto; Charing C Chong; Jae Hoon Lee; Mikhail Efanov; T Peter Kingham; Robert P Sutcliffe; Roberto I Troisi; Johann Pratschke; Xiaoying Wang; Mathieu D'Hondt; Chung Ngai Tang; Rong Liu; James O Park; Fernando Rotellar; Olivier Scatton; Atsushi Sugioka; Tran Cong Duy Long; Chung-Yip Chan; David Fuks; Ho-Seong Han; Brian K P Goh Journal: Br J Surg Date: 2022-03-15 Impact factor: 6.939
Authors: Darren W Chua; Nicholas Syn; Ye-Xin Koh; Jin-Yao Teo; Peng-Chung Cheow; Alexander Y F Chung; Chung-Yip Chan; Brian K P Goh Journal: Surg Endosc Date: 2022-08-23 Impact factor: 3.453
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Authors: Rebecca Marino; Pim B Olthof; Hong J Shi; Khe T C Tran; Jan N M Ijzermans; Türkan Terkivatan Journal: World J Surg Date: 2022-09-26 Impact factor: 3.282
Authors: Sneha Rajiv Jain; Wilson Sim; Cheng Han Ng; Yip Han Chin; Wen Hui Lim; Nicholas L Syn; Nur Haidah Bte Ahmad Kamal; Mehek Gupta; Valerie Heong; Xiao Wen Lee; Nur Sabrina Sapari; Xue Qing Koh; Zul Fazreen Adam Isa; Lucius Ho; Caitlin O'Hara; Arvindh Ulagapan; Shi Yu Gu; Kashyap Shroff; Rei Chern Weng; Joey S Y Lim; Diana Lim; Brendan Pang; Lai Kuan Ng; Andrea Wong; Ross Andrew Soo; Wei Peng Yong; Cheng Ean Chee; Soo-Chin Lee; Boon-Cher Goh; Richie Soong; David S P Tan Journal: Front Oncol Date: 2021-09-24 Impact factor: 6.244