Boston - American Association for Thoracic Surgery

AMERICAN ASSOCIATION FOR THORACIC SURGERY15. Learning Curves for Video-Assisted Thoracic Surgery Lobectomyin Non-Small Cell Lung CancerHyun-Sung Lee, Byung-Ho Nam, Jae Ill ZoCenter for Lung Cancer, National Cancer Center, Goyang, Gyeonggi, South KoreaInvited Discussant: Bryan F. MeyersOBJECTIVE: Video-assisted thoracic surgery (VATS) demands mastery of a steeplearning curve. Defining a learning curve in VATS is useful for planning trainingprograms or clinical trials. This study aimed to define the learning curves for VATSlobectomy for lung cancer by evaluating early surgical outcome data from sing thoracicsurgeon.METHODS: This study analyzed data from 126 consecutive patients undergoingVATS lobectomy for lung cancer between 2005 and 2008. VATS lobectomy wasdefined as anatomical resection without rib spreading using utility incision (figure 1).Mediastinal lymph node dissection was routinely performed. The learning curveswere generated using moving average method to assess changes in operation timeand cumulative sum(CUSUM) analysis to assess changes in failure rates [failure =conversion to open surgery, major perioperative complications or mortality, or prolongedoperation time over 6 hours]. Also, the learning curve was generatedaccording to the operation sites.MONDAYAfternoonRESULTS: Mean age was 61 years old and male was 64 patients (51%). Adenocarcinomawas 93 patients (74%) with 2.7 cm in mean size of tumor. The mean numberof harvested lymph nodes was 27 in eight nodal stations. Mean operation timewas 206 minutes.97