التفاصيل البيبلوغرافية
| العنوان: |
The Feasibility, Proficiency, and Mastery Learning Curves in 635 Robotic Pancreatoduodenectomies Following a Multicenter Training Program: 'standing on the Shoulders of Giants' |
| المؤلفون: |
Zwart, Maurice J.W., Van Den Broek, Bram, De Graaf, Nine, Suurmeijer, José A., Augustinus, Simone, Te Riele, Wouter W., Van Santvoort, Hjalmar C., Hagendoorn, Jeroen, Borel Rinkes, Inne H.M., Van Dam, Jacob L., Takagi, Kosei, Tran, Khé T.C., Schreinemakers, Jennifer, Van Der Schelling, George, Wijsman, Jan H., De Wilde, Roeland F., Festen, Sebastiaan, Daams, Freek, Luyer, Misha D., De Hingh, Ignace H.J.T., Mieog, Jan S.D., Bonsing, Bert A., Lips, Daan J., Abu Hilal, Mohamed, Busch, Olivier R., Saint-Marc, Olivier, Zeh, Herbert J., Zureikat, Amer H., Hogg, Melissa E., Koerkamp, Bas G., Molenaar, Isaac Q., Besselink, Marc G. |
| المساهمون: |
CTC, MS CGO, MS HOD, Cancer, Regenerative Medicine and Stem Cells |
| سنة النشر: |
2023 |
| مصطلحات موضوعية: |
clinical outcomes, learning curve, robotic pancreatoduodenectomy, robotic surgery, Surgery |
| الوصف: |
Objective: To assess the feasibility, proficiency, and mastery learning curves for robotic pancreatoduodenectomy (RPD) in "second-generation" RPD centers following a multicenter training program adhering to the IDEAL framework. Background: The long learning curves for RPD reported from "pioneering" expert centers may discourage centers interested in starting an RPD program. However, the feasibility, proficiency, and mastery learning curves may be shorter in "second-generation" centers that participated in dedicated RPD training programs, although data are lacking. We report on the learning curves for RPD in "second-generation" centers trained in a dedicated nationwide program. Methods: Post hoc analysis of all consecutive patients undergoing RPD in 7 centers that participated in the LAELAPS-3 training program, each with a minimum annual volume of 50 pancreatoduodenectomies, using the mandatory Dutch Pancreatic Cancer Audit (March 2016-December 2021). Cumulative sum analysis determined cutoffs for the 3 learning curves: operative time for the feasibility (1) risk-adjusted major complication (Clavien-Dindo grade ≥III) for the proficiency, (2) and textbook outcome for the mastery, (3) learning curve. Outcomes before and after the cutoffs were compared for the proficiency and mastery learning curves. A survey was used to assess changes in practice and the most valued "lessons learned." Results: Overall, 635 RPD were performed by 17 trained surgeons, with a conversion rate of 6.6% (n=42). The median annual volume of RPD per center was 22.5±6.8. From 2016 to 2021, the nationwide annual use of RPD increased from 0% to 23% whereas the use of laparoscopic pancreatoduodenectomy decreased from 15% to 0%. The rate of major complications was 36.9% (n=234), surgical site infection 6.3% (n=40), postoperative pancreatic fistula (grade B/C) 26.9% (n=171), and 30-day/in-hospital mortality 3.5% (n=22). Cutoffs for the feasibility, proficiency, and mastery learning curves were reached at 15, 62, and 84 RPD. Major morbidity and ... |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
English |
| تدمد: |
0003-4932 |
| العلاقة: |
https://dspace.library.uu.nl/handle/1874/450649Test |
| الإتاحة: |
https://dspace.library.uu.nl/handle/1874/450649Test |
| حقوق: |
info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: |
edsbas.E894E200 |
| قاعدة البيانات: |
BASE |
