Learning curves in minimally invasive esophagectomy.

Autor:	van Workum F; Department of Surgery, Radboud University Medical Center, Nijmegen 6500 HB, Netherlands. frans.vanworkum@radboudumc.nl., Fransen L; Department of Surgery, Catharina Hospital, Eindhoven 5602 ZA, Netherlands., Luyer MD; Department of Surgery, Catharina Hospital, Eindhoven 5602 ZA, Netherlands., Rosman C; Department of Surgery, Radboud University Medical Center, Nijmegen 6500 HB, Netherlands.
Jazyk:	angličtina
Zdroj:	World journal of gastroenterology [World J Gastroenterol] 2018 Nov 28; Vol. 24 (44), pp. 4974-4978.
DOI:	10.3748/wjg.v24.i44.4974
Abstrakt:	Surgical innovation and pioneering are important for improving patient outcome, but can be associated with learning curves. Although learning curves in surgery are a recognized problem, the impact of surgical learning curves is increasing, due to increasing complexity of innovative surgical procedures, the rapid rate at which new interventions are implemented and a decrease in relative effectiveness of new interventions compared to old interventions. For minimally invasive esophagectomy (MIE), there is now robust evidence that implementation can lead to significant learning associated morbidity (morbidity during a learning curve, that could have been avoided if patients were operated by surgeons that have completed the learning curve). This article provides an overview of the evidence of the impact of learning curves after implementation of MIE. In addition, caveats for implementation and available evidence regarding factors that are important for safe implementation and safe pioneering of MIE are discussed. Competing Interests: Conflict-of-interest statement: The authors have no conflict of interest to declare. The work has not been previously published and has not been submitted for publication elsewhere.
Databáze:	MEDLINE
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