The learning curve for endoscopic thyroidectomy: a single surgeon's experience.
BACKGROUND
Endoscopic thyroidectomy has been known to surgeons for only 20 years. Related studies still are needed to make up for the deficiency of clinical experience. Research on the learning curve for the endoscopic thyroidectomy could be the method for investigating the operation experience.


METHODS
This retrospective study investigated 300 consecutive patients who underwent endoscopic thyroidectomy by a single endoscopist during the past 7 years. The study population was equally divided into 10 groups chronologically. Pearson's chi-square test and one-way analysis of variance were used to compare differences in the demographic data, operative time, operation score system, and follow-up data.


RESULTS
The mean operative time was 98.07 min. The mean operation score was 6.00, and the rate of conversion to open surgery was 3.7%. There were no differences in demographic data or complications among the 10 groups. Subcutaneous edema occurred in five cases and transient recurrent laryngeal nerve palsy in five cases. There were significant differences in the mean operative time (p < 0.01) and the mean operation score (p < 0.01) among the 10 groups. Comparison of two neighboring groups showed differences in both operative time (p < 0.05) and operation score (p < 0.01) between groups 2 and 3 and in operation score between groups 5 and 6 (p < 0.05).


CONCLUSIONS
The first 60 cases constitute the early stage of the learning curve for endoscopic thyroidectomy. The proficiency and stability of the operation reach the advanced level after 150 cases.
Liu
Sheng
S
18-F Minimally Invasive Surgical Center, Changzheng Hospital, Fengyang Road 415, Shanghai, 200003, China.
Qiu
Ming
M
Jiang
Dao-Zhen
DZ
Zheng
Xiang-Min
XM
Zhang
Wei
W
Shen
Hong-Liang
HL
Shan
Cheng-Xiang
CX
D000293:Adolescent; D000328:Adult; D002983:Clinical Competence; D004724:Endoscopy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000601:surgery; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods* / Q000706:statistics & numerical data; D014826:Vocal Cord Paralysis / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult