Cumulative sum analysis of the learning curve for endoscopic resection of juvenile nasopharyngeal angiofibroma

Song, Xiaole; Wang, Dehui; Sun, Xicai; Wang, Jingjing; Liu, Zhuofu; Liu, Quan; Gu, Yurong

doi:10.1007/s00464-018-6035-1

Cited by 15 publications

(15 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previously published work has established a learning curve for individual surgeon performance with respect to JNA surgery, demonstrating shorter operating times and reduced risk of recurrence with greater experience. 14 Such would be expected to be true with regard to institutional outcomes as well, with higher volume experience translating into improved outcomes as defined by successful tumor resection with minimized complication risk.…”

Section: Discussionmentioning

confidence: 99%

Juvenile Nasopharyngeal Angiofibroma: Outcomes Analysis Based Upon Hospital Volume

et al. 2023

View full text Add to dashboard Cite

ObjectiveTo evaluate the management of juvenile nasopharyngeal angiofibroma (JNA) from a national perspective with outcomes comparison based on hospital volume.Study DesignTen‐year Pediatric Health Information Systems (PHIS) data analysis.MethodsThe PHIS database was queried for the diagnosis of JNA. Data regarding demographics, surgical approach, embolization, length of stay, charges, readmission, and revision surgery was collected and analyzed. Hospitals were classified as low volume if fewer than 10 cases and high volume if greater than or equal to 10 cases during the study period. A random effects model compared outcomes based on hospital volume.ResultsA total of 287 JNA patients were identified with a mean age of 13.8 (± 2.7) years. Nine hospitals were classified as high volume, accounting for a total of 121 patients. The mean length of hospitalization, blood transfusion rate, and 30‐day readmissions did not differ significantly by hospital volume. Patients cared for at high‐volume institutions were less likely to require postoperative mechanical ventilation (8.3% vs. 25.0%; adjusted RR = 0.32; 95% CI 0.14–0.73; p < 0.01) or return to the operating room for residual disease than patients admitted to low‐volume hospitals (7.4% vs. 20.5%; adjusted RR = 0.38; 95% CI 0.18–0.79; p = 0.01).ConclusionsThe management of JNA is complex from both an operative and perioperative management standpoint. Over the past decade, nearly half (42.2%) of JNA patients have been managed at nine institutions in the United States. These centers have significantly lower rates of postoperative mechanical ventilation and the need for revision surgery.Level of Evidence3 Laryngoscope, 2023

show abstract

Section: Discussionmentioning

confidence: 99%

Juvenile Nasopharyngeal Angiofibroma: Outcomes Analysis Based Upon Hospital Volume

et al. 2023

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Several studies have evaluated the learning curves of different surgical procedures [13,[28][29][30][31]. In these studies, learning curves were analyzed with respect to rates of surgical failure or perioperative complications as well as the operation time using quantitative statistical methods [13,[28][29][30][31]. The learning curve for robotic thyroid surgery with regard to the operation time has been evaluated several times since robotic surgery was introduced to the field of thyroid surgery in South Korea in 2007 [5][6][7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

The Learning Curve of Robotic Thyroid Surgery and the Avoidance of Temporary Hypoparathyroidism after Total Thyroidectomy and Concomitant Central Compartment Node Dissection: A Single Surgeon’s Experience

et al. 2019

View full text Add to dashboard Cite

The aim of this study was to evaluate the learning curve of robotic thyroid surgery with regard to both operation time and temporary hypoparathyroidism using quantitative statistical analysis. A total of 194 patients who underwent total thyroidectomy and concomitant central compartment node dissection for papillary thyroid carcinoma by a single surgeon between December 2008 and September 2017 were enrolled. The learning curve for operation time was assessed using the cumulative sum (CUSUM) technique, and the number of procedures required to reduce the incidence of temporary hypoparathyroidism to less than 30% was determined using the CUSUM and risk-adjusted CUSUM (RA-CUSUM) techniques. The learning curve for operation time was divided into three phases: phase 1 (the initial learning period, 1st–19th cases), phase 2 (the challenging period, 20th–121st cases), and phase 3 (the competent phase, 122nd–194th cases). To reduce the incidence of temporary hypoparathyroidism to <30% required 119 cases, and after adjustment for potential risk factors by RA-CUSUM analysis this extended to 173 cases. Technical proficiency for robotic thyroid surgery with respect to the avoidance of surgical complications probably requires a longer learning period than that required for operation time.

show abstract

“…Estudios hechos por Xiaole Song et al , mencionan a los niveles alto de HIF-1α (factor 1α inducible por hipoxia) en las células epiteliales de los tejidos JNA así como también CREG (represor celular de genes estimulados por E1A), OPN (osteopontina), c-Src (proto oncogene tirosinaproteína quinasa Src) y VEGF (facto vascular endotelial de crecimiento), como marcadores significativos de recurrencia y progresión del tumor. Otros autores como Joel W. Jones et al hacen referencia a la inhibición de los ejes de señalización de VEGF (factor vascular de crecimiento endotelial) y FGFR ( factor de crecimiento de fibroblastos) puede tener potencial terapéutico (22)(23)(24)(25)(26)(27) .…”

Section: Discusionunclassified

Experiencia en el tratamiento quirúrgico del angiofibroma nasal juvenil en Hospital de Especialidades No 2 Lic. Luis Donaldo Colosio Murrieta. Instituto Mexicano del Seguro Social de Ciudad Obregón, Sonora

et al. 2018

View full text Add to dashboard Cite

Objetivo: Exponer nuestra experiencia y evaluar la recurrencia en el manejo quirúrgico del angiofibroma nasal juvenil, abordaje abierto contra endoscópico, en el servicio de otorrinolaringología del noroeste del país. Materiales y métodos: Estudio observacional, retrospectivo, analítico. Se revisaron los expedientes clínicos de los pacientes con diagnóstico de angiofibroma nasal juvenil de 2014 a 2017, atendidos en el Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello de esta institución. Resultados: Un total de 19 pacientes con diagnóstico de angiofibroma nasal juvenil, fueron sometidos a un procedimiento quirúrgico, 14 abiertos y 5 endoscópicos, la recurrencia fue de 50 % y 40 % respectivamente, lo cual no fue estadísticamente significativo (p=0.88). No obstante, se contrastaron otras variables, como la necesidad de la Unidad de Cuidados Intensivos (UCI) para ambos grupos, 71 % en abordaje abierto y 20 % para el endoscópico, en lo cual si encontramos diferencia significativa (p=0.04). Conclusiones: El estudio no muestra una ventaja estadísticamente significativa del abordaje endoscópico frente al abordaje abierto, pero sí una menor necesidad de hospitalización en UCI, lo que reduciría los costos de atención.

show abstract

Cumulative sum analysis of the learning curve for endoscopic resection of juvenile nasopharyngeal angiofibroma

Abstract: 4.

Cited by 15 publications

References 33 publications

Juvenile Nasopharyngeal Angiofibroma: Outcomes Analysis Based Upon Hospital Volume

Juvenile Nasopharyngeal Angiofibroma: Outcomes Analysis Based Upon Hospital Volume

The Learning Curve of Robotic Thyroid Surgery and the Avoidance of Temporary Hypoparathyroidism after Total Thyroidectomy and Concomitant Central Compartment Node Dissection: A Single Surgeon’s Experience

Experiencia en el tratamiento quirúrgico del angiofibroma nasal juvenil en Hospital de Especialidades No 2 Lic. Luis Donaldo Colosio Murrieta. Instituto Mexicano del Seguro Social de Ciudad Obregón, Sonora

Contact Info

Product

Resources

About