The learning curve for thoracoscopic repair of esophageal atresia with distal tracheoesophageal fistula: A cumulative sum analysis
- Authors
- Kim, W.[Kim, W.]; Son, J.[Son, J.]; Lee, S.[Lee, S.]; Seo, J.-M.[Seo, J.-M.]
- Issue Date
- Nov-2020
- Publisher
- W.B. Saunders
- Keywords
- CUSUM; Esophageal atresia; Learning curve; Minimally invasive surgery; Thoracoscopy; Tracheoesophageal fistula
- Citation
- Journal of Pediatric Surgery, v.55, no.11, pp.2527 - 2530
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Pediatric Surgery
- Volume
- 55
- Number
- 11
- Start Page
- 2527
- End Page
- 2530
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/6282
- DOI
- 10.1016/j.jpedsurg.2020.06.005
- ISSN
- 0022-3468
- Abstract
- Background: Thoracoscopic repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) remains technically challenging due to the rarity of these procedures. The aim of this study is to report our experience with thoracoscopic repair of type C EA/TEF and to evaluate the learning curve based upon the surgeon's skill level. Methods: We retrospectively reviewed data of thoracoscopic EA/TEF repair performed in our center between October 2008 and May 2019. The learning curve was evaluated using the cumulative sum (CUSUM) method based on operative time. Results: Of the 50 consecutive cases evaluated, the mean birth weight was 2634 ± 608 g and the median age at operation was 3 days (range, 1–29 days). The mean operation time was 144 ± 65 min. Anastomosis leakage occurred in 3 cases (6%) and strictures requiring balloon dilatations occurred in 16 cases (32%). The CUSUM analysis evaluated a learning curve of approximately 10 cases of thoracoscopic type C EA/TEF repair. A lower gestational age was associated with longer operation time. Conclusions: Thoracoscopic repair of type C EA/TEF is a feasible and safe procedure. The number of procedures required to achieve a stable learning curve was 10. The learning phase may be shortened by adequate set-up under the supervision of an expert endoscopic surgeon. Type of study: Retrospective Comparative Treatment Study. Level of evidence: III © 2020 Elsevier Inc.
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