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Tarallo M, Crocetti D, Gurrado A, Iorio O, Iossa A, Caruso D, Bononi M, Stabilini C, Bracale U, Chiappini A, Testini M, Avenia N, Polistena A, Cavallaro G. Achieving the learning curve in total thyroidectomy: a prospective evaluation on resident's training by CUSUM and KPSS analysis. Ann R Coll Surg Engl 2022; 104:414-420. [PMID: 35175830 PMCID: PMC9157995 DOI: 10.1308/rcsann.2021.0318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Total thyroidectomy (TT) is one of the most common procedures among general and endocrine surgeons worldwide. The conventional approach by neck incision is still the most frequently used, despite the growth of mini-invasive approaches. Controversies exist about the optimal learning curve for resident surgeons approaching this procedure. The aim of this study was to compare TT performed by experienced surgeons and residents in two academic hospitals, to define the correct shape of the specific learning curve. METHODS Between January 2016 and December 2018 patients undergoing TT in two academic departments were prospectively enrolled. In each department patients were divided into four groups: a reference group (A), consisting of 50 consecutive patients operated on by a senior surgeon, and three other groups (B, C, D) of 50 patients each where thyroidectomy was carried out by three different general surgery residents in their last 3 years of residency, respectively. Data were analysed by CUSUM and KPSS tests in order to compare operative time (OT) and its stabilisation during the learning curve. RESULTS Data from CUSUM test reported that residents could perform TT with OT similar to the senior surgeon after approximately 25-30 procedures, while the KPSS test showed that residents became more stable after 30 procedures, with no increase in perioperative complications. CONCLUSIONS This prospective study shows how a specific training in thyroid surgery can be reliable thanks to experienced tutors, and confirmed that the effect of dedicated and programmed training may result in positive outcomes for patients requiring thyroidectomy.
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Affiliation(s)
| | | | | | - O Iorio
- A. Spaziani Hospital, Frosinone (FR), Italy
| | - A Iossa
- Sapienza University, Rome, Italy
| | - D Caruso
- Sapienza University, Rome, Italy
| | - M Bononi
- Sapienza University, Rome, Italy
| | | | - U Bracale
- Federico II University Hospital, Naples, Italy
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DeAsis F, Gitelis M, Chao S, Lapin B, Linn J, Denham W, Haggerty S, Carbray J, Ujiki M, Olory-Togbe JL, Gbessi DG, Dossou FM, Lawani I, Souaibou YI, Gnangnon I, Denakpo M, Soton RR, Djrouo G, Gogan P, Trukhalev W, Kukosh M, Panyushkin A, Safronova E, Jairam A, Kaufmann R, Jeekel J, Lange JF, Volmer U, Kersten CC, Arlt G, Skach J, Harcubova R, Petrakova V, Mandoboy JD, Ngom G, Faye AL, Ndour O, Sankale AA, Ndoye M, Daneiii P, Leone N, Ballerini A, Bondurri A, Cavallaro G, Silecchia G, Raparelli L, Greco F, Iorio O, Iossa A, De Angelis F, Rizzello M, Olmi S, Cesana G, Baldazzi G, Manoocheri F, Campanile FC, Munipalle P, Khan S, Gwiti P, Kanakala V, Viswanath Y, Kokotovic D, Sjølander H, Gögenur I, Helgstrand F, Devadhar S, Hounnou G, Elegbede OTA, Hadonou AA, Mensah ED, Agossou-Voyeme AK, Konate I, Toure AO, Cisse M, Zaki M, Diao ML, Tendeng JN, Toure FB, Toure CT, Subramanian V, Froghi F, de Carvalho FC, Salimin L, Drabble E. Humbilical & Epigastric Hernia. Hernia 2015; 19 Suppl 1:S35-42. [PMID: 26518843 DOI: 10.1007/bf03355324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F DeAsis
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA
| | - M Gitelis
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA
| | - S Chao
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA
| | - B Lapin
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA
| | - J Linn
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA.,Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, USA
| | - W Denham
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA.,Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, USA
| | - S Haggerty
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA.,Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, USA
| | - J Carbray
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA
| | - M Ujiki
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA.,Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, USA
| | | | - D G Gbessi
- Faculté des sciences de la Santé, Foto, Benin
| | - F M Dossou
- Faculté des sciences de la Santé, Foto, Benin
| | - I Lawani
- Faculté des sciences de la Santé, Foto, Benin
| | | | - I Gnangnon
- Faculté des sciences de la Santé, Foto, Benin
| | - M Denakpo
- Faculté des sciences de la Santé, Foto, Benin
| | - R R Soton
- Faculté des sciences de la Santé, Foto, Benin
| | - G Djrouo
- Faculté des sciences de la Santé, Foto, Benin
| | - P Gogan
- Faculté des sciences de la Santé, Foto, Benin
| | - W Trukhalev
- State Medical Academy, Nizhnij Novgorod, Russia
| | - M Kukosh
- State Medical Academy, Nizhnij Novgorod, Russia
| | | | | | - A Jairam
- Department of Surgery, Erasmus Medical Centre, Rotterdam, Netherlands
| | - R Kaufmann
- Department of Surgery, Erasmus Medical Centre, Rotterdam, Netherlands
| | - J Jeekel
- Department of Neuroscience, Erasmus Medical Centre, Rotterdam, Netherlands
| | - J F Lange
- Department of Surgery, Erasmus Medical Centre, Rotterdam, Netherlands
| | - U Volmer
- Department of Surgery, Park-Klinik Weissensee, Berlin, Germany
| | | | | | - J Skach
- Hernia Center, Regional Hospital Liberec, Liberec, Czech Republic
| | - R Harcubova
- Hernia Center, Regional Hospital Liberec, Liberec, Czech Republic
| | - V Petrakova
- Hernia Center, Regional Hospital Liberec, Liberec, Czech Republic
| | - J Danga Mandoboy
- Pediatric surgery service of Aristide Le Dantec Hospital, Dakar, Senegal
| | - G Ngom
- Pediatric surgery service of Aristide Le Dantec Hospital, Dakar, Senegal
| | - A L Faye
- Pediatric surgery service of Aristide Le Dantec Hospital, Dakar, Senegal
| | - O Ndour
- Pediatric surgery service of Aristide Le Dantec Hospital, Dakar, Senegal
| | - A A Sankale
- Pediatric surgery service of Aristide Le Dantec Hospital, Dakar, Senegal
| | - M Ndoye
- Pediatric surgery service of Aristide Le Dantec Hospital, Dakar, Senegal
| | | | | | | | | | - G Cavallaro
- Department of Medico - Surgical Sciences and Biotechnologies & Bariatric Center of Excellence, Sapienza University, Rome, Italy
| | - G Silecchia
- Department of Medico - Surgical Sciences and Biotechnologies & Bariatric Center of Excellence, Sapienza University, Rome, Italy
| | - L Raparelli
- General Surgery Unit, GB Grassi Hospital, Rome, Italy
| | - F Greco
- General Surgery Unit, Andosilla Hospital, Civita Castellana, VT, Italy
| | - O Iorio
- Department of Medico - Surgical Sciences and Biotechnologies & Bariatric Center of Excellence, Sapienza University, Rome, Italy
| | - A Iossa
- Department of Medico - Surgical Sciences and Biotechnologies & Bariatric Center of Excellence, Sapienza University, Rome, Italy
| | - F De Angelis
- Department of Medico - Surgical Sciences and Biotechnologies & Bariatric Center of Excellence, Sapienza University, Rome, Italy
| | - M Rizzello
- Department of Medico - Surgical Sciences and Biotechnologies & Bariatric Center of Excellence, Sapienza University, Rome, Italy
| | - S Olmi
- General and Oncologic Surgery Unit, San Marco Hospital, Zingonia, BG, Italy
| | - G Cesana
- General and Oncologic Surgery Unit, San Marco Hospital, Zingonia, BG, Italy
| | - G Baldazzi
- General and Mini-invasive Surgery Unit, Abano Terme Hospital, Abano Terme, PD, Italy
| | - F Manoocheri
- General and Mini-invasive Surgery Unit, Abano Terme Hospital, Abano Terme, PD, Italy
| | - F C Campanile
- General Surgery Unit, Andosilla Hospital, Civita Castellana, VT, Italy
| | - P Munipalle
- James Cook University Hospital, Middlesbrough, UK
| | | | | | | | | | - D Kokotovic
- Dept. of Surgery, Køge Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | - S Devadhar
- Department of Surgery, Pune India, Devadhar Nursing Home, Pune, India
| | - G Hounnou
- CNHU, Clinique Universitaire de Chirurgie Pédiatrique, 03 BP 386, Cotonou, Benin
| | - O T A Elegbede
- CNHU, Clinique Universitaire de Chirurgie Pédiatrique, 03 BP 386, Cotonou, Benin
| | - A A Hadonou
- CNHU, Clinique Universitaire de Chirurgie Pédiatrique, 03 BP 386, Cotonou, Benin
| | - E D Mensah
- CHD/B, Service de Chirurgie Générale, Parakou, Benin
| | - A K Agossou-Voyeme
- CNHU, Clinique Universitaire de Chirurgie Pédiatrique, 03 BP 386, Cotonou, Benin
| | - I Konate
- Departement of Surgery, University Gaston Berger, Saint Louis, Senegal
| | - A O Toure
- Departement of Surgery, University Cheikh Anta Diop, Dakar, Senegal
| | - M Cisse
- Departement of Surgery, University Cheikh Anta Diop, Dakar, Senegal
| | - M Zaki
- Departement of Surgery, University Cheikh Anta Diop, Dakar, Senegal
| | - M L Diao
- Departement of Surgery, University Gaston Berger, Saint Louis, Senegal
| | - J N Tendeng
- Departement of Surgery, University Gaston Berger, Saint Louis, Senegal
| | - F B Toure
- Departement of Surgery, University Gaston Berger, Saint Louis, Senegal
| | - C T Toure
- Departement of Surgery, University Cheikh Anta Diop, Dakar, Senegal
| | | | - F Froghi
- Plymouth Hospitals NHS Trust, Plymouth, UK
| | | | - L Salimin
- Plymouth Hospitals NHS Trust, Plymouth, UK
| | - E Drabble
- Plymouth Hospitals NHS Trust, Plymouth, UK
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