Federico Leone1, Silvia De Santi2, Andrea Costantino3,4, Giulia Anna Marciante2, Alessandro Bianchi2, Giovanni Colombo2,3, Fabrizio Salamanca2,3. 1. Unit of Otorhinolaryngology-Head and Neck Surgery, Humanitas San Pio X, Via Francesco Nava, 31, 20159, Milan, Italy. federico.leone@email.com. 2. Unit of Otorhinolaryngology-Head and Neck Surgery, Humanitas San Pio X, Via Francesco Nava, 31, 20159, Milan, Italy. 3. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy. 4. Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy.
Abstract
BACKGROUND: Barbed snore surgery (BSS) was recently introduced for the management of obstructive sleep apnea (OSA) with optimistic clinical outcomes associated with a low complication rate. The purpose of the present study was to describe the surgical learning curve of the BSS to determine the effect of surgeon experience on surgical procedure time and complication rates. METHODS: Patients who underwent tonsillectomy with barbed lateral pharyngoplasty were divided in two different groups based on surgeon experience. Operative time, intraoperative blood loss, intra- and post-operative complications, and hospitalization time were compared. RESULTS: A total of 144 consecutive patients (F: 27; mean age: 47.5 years, SD 9.7) were included. All procedures were successfully completed in 37.0 min (IQR 29.0-47.0). Senior surgeons completed the procedure in 33.0 min (IQR 27.0-41.0), while junior surgeons needed 52.0 min (IQR 36.5-64.5) (p < .05). No intra-operative complications were observed, and intra-operative blood loss was minimal in both groups. No difference was measured in terms of hospitalization time. Only one post-operative bleeding resolved with conservative treatment was detected in both groups. Junior surgeons showed a positive trend in the reduction of operative time (r = - 2.32, 95% CI: - 2.74 to - 1.90; p < .05). CONCLUSIONS: The findings suggest that BSS may be safely performed by inexperienced surgeons with no increased risk of intra- and post-operative complications. The surgical LC is short and the junior surgeon can reach the ability of senior surgeons after a few number of procedures with a progressive reduction of the operative time.
BACKGROUND: Barbed snore surgery (BSS) was recently introduced for the management of obstructive sleep apnea (OSA) with optimistic clinical outcomes associated with a low complication rate. The purpose of the present study was to describe the surgical learning curve of the BSS to determine the effect of surgeon experience on surgical procedure time and complication rates. METHODS: Patients who underwent tonsillectomy with barbed lateral pharyngoplasty were divided in two different groups based on surgeon experience. Operative time, intraoperative blood loss, intra- and post-operative complications, and hospitalization time were compared. RESULTS: A total of 144 consecutive patients (F: 27; mean age: 47.5 years, SD 9.7) were included. All procedures were successfully completed in 37.0 min (IQR 29.0-47.0). Senior surgeons completed the procedure in 33.0 min (IQR 27.0-41.0), while junior surgeons needed 52.0 min (IQR 36.5-64.5) (p < .05). No intra-operative complications were observed, and intra-operative blood loss was minimal in both groups. No difference was measured in terms of hospitalization time. Only one post-operative bleeding resolved with conservative treatment was detected in both groups. Junior surgeons showed a positive trend in the reduction of operative time (r = - 2.32, 95% CI: - 2.74 to - 1.90; p < .05). CONCLUSIONS: The findings suggest that BSS may be safely performed by inexperienced surgeons with no increased risk of intra- and post-operative complications. The surgical LC is short and the junior surgeon can reach the ability of senior surgeons after a few number of procedures with a progressive reduction of the operative time.
Authors: M Mantovani; A Minetti; S Torretta; A Pincherle; G Tassone; L Pignataro Journal: Acta Otorhinolaryngol Ital Date: 2013-04 Impact factor: 2.124
Authors: Hilliary N White; John Frederick; Terence Zimmerman; William R Carroll; J Scott Magnuson Journal: JAMA Otolaryngol Head Neck Surg Date: 2013-06 Impact factor: 6.223