title: The Learning Curve of Transareola Single-site Laparoendoscopic Thyroidectomy: CUSUM Analysis of a Single Surgeon's Experience.
abstract: BACKGROUND
  Transareola single-site laparoendoscopic thyroidectomy (TASSET) is a rapidly advancing minimally invasive procedure. The purpose of this study was to evaluate the learning curve for TASSET.
  
  
  METHODS
  Forty-five consecutive patients were prospectively divided into group 1 (initial phase), group 2 (intermediate phase), and group 3 (advanced phase) according to their surgical order (15 patients in each group). The operative time, operative blood loss, duration of hospital stay, postoperative pain, and postoperative complications were compared using phases.
  
  
  RESULTS
  Statistically significant differences were observed in the different learning phases, among operative time (P<0.05), operative blood loss (P<0.05), hospital stay (P<0.05), and postoperative pain (P<0.05). The postoperative complication rate was low (3/45).
  
  
  CONCLUSIONS
  Learning curve of the TASSET are improved synchronized at different phases and technical indicators. The establishment of operative space take longer time to skilled master.
authors.affiliation: Department of General Surgery, Fengxian Central Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Guanghui
authors.initials: G
authors.lastname: Zhu
authors.forename: Xueli
authors.initials: X
authors.lastname: Zhang
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Tang
authors.forename: Zhanhai
authors.initials: Z
authors.lastname: Tan
authors.forename: Jianrong
authors.initials: J
authors.lastname: Chen
authors.forename: Yuanzhou
authors.initials: Y
authors.lastname: Shan
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002983:Clinical Competence / Q000592:standards; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000592:standards*; D059032:Learning Curve; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009558:Nipples; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D066231:Surgeons / Q000592:standards; D013965:Thyroidectomy / Q000379:methods / Q000592:standards*; D016896:Treatment Outcome