Archives of otolaryngology--head & neck surgery · 2010
The learning curve of sialendoscopy with modular sialendoscopes: a single surgeon's experience.
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Luers Jan Christoffer, Damm Michael, Klussmann Jens Peter, Beutner Dirk
Аннотация
OBJECTIVE: To assess the learning curve of sialendoscopy with modular endoscopes based on operative parameters and a postoperative performance rating.
DESIGN: Prospective study, case series.
SETTING: Tertiary referral hospital.
PATIENTS: The study included 50 consecutive patients who underwent sialendoscopy by a single surgeon (J.C.L.) between September 2007 and March 2009 at University Hospital of Cologne, Cologne, Germany. The patients were chronologically arranged into 5 groups of 10 patients.
INTERVENTIONS: Diagnostic and interventional sialendoscopy using local anesthesia.
MAIN OUTCOME MEASURES: Operative parameters and postoperative performance ratings.
RESULTS: The average operative time was 39 minutes, with a ratio of diagnostic to interventional sialendoscopy of 62%:38%. There was a significant improvement in the average operative time (P < .001) and in the average performance rating (P = .007) after the first 10 patients and again after the first 30 patients (P = .003 and P = .01, respectively). A continuous decrease in operation time was measurable up to the last patients. Performance ratings reached a level of excellence within the last group of patients.
CONCLUSIONS: The performance of sialendoscopy improves with time and experience. With endoscopes of a modular design, the surgeons have a remarkable learning curve. The surgeons' learning curve in this study required 30 cases to reach satisfactory operation times and performance ratings. Both parameters showed continuous improvement and a leveling off after 50 cases.
DESIGN: Prospective study, case series.
SETTING: Tertiary referral hospital.
PATIENTS: The study included 50 consecutive patients who underwent sialendoscopy by a single surgeon (J.C.L.) between September 2007 and March 2009 at University Hospital of Cologne, Cologne, Germany. The patients were chronologically arranged into 5 groups of 10 patients.
INTERVENTIONS: Diagnostic and interventional sialendoscopy using local anesthesia.
MAIN OUTCOME MEASURES: Operative parameters and postoperative performance ratings.
RESULTS: The average operative time was 39 minutes, with a ratio of diagnostic to interventional sialendoscopy of 62%:38%. There was a significant improvement in the average operative time (P < .001) and in the average performance rating (P = .007) after the first 10 patients and again after the first 30 patients (P = .003 and P = .01, respectively). A continuous decrease in operation time was measurable up to the last patients. Performance ratings reached a level of excellence within the last group of patients.
CONCLUSIONS: The performance of sialendoscopy improves with time and experience. With endoscopes of a modular design, the surgeons have a remarkable learning curve. The surgeons' learning curve in this study required 30 cases to reach satisfactory operation times and performance ratings. Both parameters showed continuous improvement and a leveling off after 50 cases.
Предметные рубрики MeSH
AdultAgedAnesthesia, LocalCurriculumEducation, Medical, ContinuingEndoscopesFemaleGermanyHospitals, UniversityHumansMaleMiddle AgedMinimally Invasive Surgical ProceduresOtorhinolaryngologic Surgical ProceduresParotid GlandSalivary Gland CalculiSubmandibular GlandSurgical InstrumentsTime and Motion StudiesYoung Adult