title: The learning progression of diagnostic sialendoscopy.
abstract: BACKGROUND
  Sialendoscopy is becoming the gold standard procedure for diagnosis and treatment of Salivary Gland Inflammatory Diseases.
  
  
  OBJECTIVE
  To evaluate the learning progression of a single surgeon to implement and perform diagnostic sialendoscopy: to estimate how many procedures were necessary to achieve better results; if it was higher rate of complications in the beginning.
  
  
  METHODS
  Retrospective analysis involving 113 consecutive sialendoscopies performed from 2010 to 2013. According to a descriptive analysis of the factors related to surgeon's experience, the casuistic was divided into two groups: group (A) comprising the first 50 exams, and group (B) the last 63. Groups were then compared concerning demographic and peri-operative aspects.
  
  
  RESULTS
  In Group A, failure to catheterize papilla were 22% versus 3% in B (p=0.001). Failure to complete examination was 30% in group A versus 6% in B (p=0.001), and necessity to repeat exams was 22% in group A versus 10% in B (p=0.058). The complication rates were 18% in group A, and 10% in B (p=0.149). Operative time was slightly shorter in group B (56 versus 41 min, p=0.045).
  
  
  CONCLUSIONS
  We found better outcomes after the first 50 diagnostic sialendoscopies. Complication rates were statistically the same between early and late groups of experience with sialendoscopy.
authors.affiliation: Cirurgia de Cabeça e Pescoço, Clínica ONCCAPE, Campinas, SP, Brazil. Electronic address: higinosteck@gmail.com.
authors.forename: José Higino
authors.initials: JH
authors.lastname: Steck
authors.affiliation: Cirurgia de Cabeça e Pescoço, Clínica ONCCAPE, Campinas, SP, Brazil.
authors.forename: Elaine
authors.initials: E
authors.lastname: Stabenow
authors.affiliation: Serviço de Cirurgia de Cabeça e Pescoço do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFM-USP), São Paulo, SP, Brazil.
authors.forename: Erivelto Martinho
authors.initials: EM
authors.lastname: Volpi
authors.affiliation: Cirurgia de Cabeça e Pescoço, Clínica ONCCAPE, Campinas, SP, Brazil.
authors.forename: Evandro Cezar Guerreiro
authors.initials: EC
authors.lastname: Vasconcelos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012466:Salivary Gland Diseases / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult
keywords: Diagnosis; Diagnóstico; Doenças da glândula salivar; Endoscopia; Endoscopy; Salivary gland diseases