The learning curve of endoscopic total mastectomy in Taiwan: A multi-center study

Chin Sheng Hung, Sheng Wei Chang, Li Min Liao, Cheng Chiao Huang, Shih Hsin Tu, Shou Tung Chen, Dar Ren Chen, Shou Jen Kuo, Hung Wen Lai, Ting Mao Chou, Yao Lung Kuo

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: Laparoscopic techniques are commonly used in abdominal and gynecologic surgery, while breast cancer surgery has remained largely unchanged. In Asia, especially in Japan, many surgeons have started to use endoscopic surgery for breast cancer. In Taiwan, endoscopy-assisted breast surgery started in 2010. The benefits of this surgical method include smaller incisions, an axillary anatomic approach, clear vision, no oncologic compromise, and good cosmetic outcomes. This is the first report to discuss the learning curve of endoscopy-assisted breast surgery, including the difficulties experienced. Materials and methods: From June 2011 to December 2013, data were collected from 134 patients who received an endoscopic total mastectomy at the Taipei Medical University Hospital (TMUH) or Changhua Christian Hospital (CCH). We divided these patients into a learning group (TMUH, n = 15; CCH, n = 15) and a mature group (TMUH, n = 50; CCH, n = 54). Patient data and perioperative variables were recorded by retrospective chart review. Variables were compared using the χ2 test and Student's t-test. Results: There was a significant difference in operation time (275.3 vs. 228.9 minutes, p < 0.01) between the learning and mature groups. Perioperative variables (lymph node dissection method, nipple preservation, and reconstruction method) were also analyzed, but there were no demographic differences between the groups. The complication rate was higher in the learning group, although this difference was also not statistically significant. Conclusion: Our study is the first to discuss the learning curve of endoscopic total mastectomy. The operation time decreased significantly after 15 cases at each hospital. Although the operation is still more time-consuming than traditional methods, it has the benefit of smaller wounds and improved cosmetic outcomes if combined with immediate reconstruction.

Original languageEnglish
Article numbere0178251
JournalPLoS One
Volume12
Issue number6
DOIs
Publication statusPublished - Jun 1 2017

Fingerprint

Simple Mastectomy
Learning Curve
Taiwan
learning
Surgery
surgery
Learning
Cosmetics
Endoscopy
endoscopy
Breast
cosmetics
Breast Neoplasms
breast neoplasms
breasts
Gynecologic Surgical Procedures
Nipples
methodology
Lymph Node Excision
Dissection

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

The learning curve of endoscopic total mastectomy in Taiwan : A multi-center study. / Hung, Chin Sheng; Chang, Sheng Wei; Liao, Li Min; Huang, Cheng Chiao; Tu, Shih Hsin; Chen, Shou Tung; Chen, Dar Ren; Kuo, Shou Jen; Lai, Hung Wen; Chou, Ting Mao; Kuo, Yao Lung.

In: PLoS One, Vol. 12, No. 6, e0178251, 01.06.2017.

Research output: Contribution to journalArticle

Hung, CS, Chang, SW, Liao, LM, Huang, CC, Tu, SH, Chen, ST, Chen, DR, Kuo, SJ, Lai, HW, Chou, TM & Kuo, YL 2017, 'The learning curve of endoscopic total mastectomy in Taiwan: A multi-center study', PLoS One, vol. 12, no. 6, e0178251. https://doi.org/10.1371/journal.pone.0178251
Hung, Chin Sheng ; Chang, Sheng Wei ; Liao, Li Min ; Huang, Cheng Chiao ; Tu, Shih Hsin ; Chen, Shou Tung ; Chen, Dar Ren ; Kuo, Shou Jen ; Lai, Hung Wen ; Chou, Ting Mao ; Kuo, Yao Lung. / The learning curve of endoscopic total mastectomy in Taiwan : A multi-center study. In: PLoS One. 2017 ; Vol. 12, No. 6.
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abstract = "Introduction: Laparoscopic techniques are commonly used in abdominal and gynecologic surgery, while breast cancer surgery has remained largely unchanged. In Asia, especially in Japan, many surgeons have started to use endoscopic surgery for breast cancer. In Taiwan, endoscopy-assisted breast surgery started in 2010. The benefits of this surgical method include smaller incisions, an axillary anatomic approach, clear vision, no oncologic compromise, and good cosmetic outcomes. This is the first report to discuss the learning curve of endoscopy-assisted breast surgery, including the difficulties experienced. Materials and methods: From June 2011 to December 2013, data were collected from 134 patients who received an endoscopic total mastectomy at the Taipei Medical University Hospital (TMUH) or Changhua Christian Hospital (CCH). We divided these patients into a learning group (TMUH, n = 15; CCH, n = 15) and a mature group (TMUH, n = 50; CCH, n = 54). Patient data and perioperative variables were recorded by retrospective chart review. Variables were compared using the χ2 test and Student's t-test. Results: There was a significant difference in operation time (275.3 vs. 228.9 minutes, p < 0.01) between the learning and mature groups. Perioperative variables (lymph node dissection method, nipple preservation, and reconstruction method) were also analyzed, but there were no demographic differences between the groups. The complication rate was higher in the learning group, although this difference was also not statistically significant. Conclusion: Our study is the first to discuss the learning curve of endoscopic total mastectomy. The operation time decreased significantly after 15 cases at each hospital. Although the operation is still more time-consuming than traditional methods, it has the benefit of smaller wounds and improved cosmetic outcomes if combined with immediate reconstruction.",
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AU - Tu, Shih Hsin

AU - Chen, Shou Tung

AU - Chen, Dar Ren

AU - Kuo, Shou Jen

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AU - Chou, Ting Mao

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N2 - Introduction: Laparoscopic techniques are commonly used in abdominal and gynecologic surgery, while breast cancer surgery has remained largely unchanged. In Asia, especially in Japan, many surgeons have started to use endoscopic surgery for breast cancer. In Taiwan, endoscopy-assisted breast surgery started in 2010. The benefits of this surgical method include smaller incisions, an axillary anatomic approach, clear vision, no oncologic compromise, and good cosmetic outcomes. This is the first report to discuss the learning curve of endoscopy-assisted breast surgery, including the difficulties experienced. Materials and methods: From June 2011 to December 2013, data were collected from 134 patients who received an endoscopic total mastectomy at the Taipei Medical University Hospital (TMUH) or Changhua Christian Hospital (CCH). We divided these patients into a learning group (TMUH, n = 15; CCH, n = 15) and a mature group (TMUH, n = 50; CCH, n = 54). Patient data and perioperative variables were recorded by retrospective chart review. Variables were compared using the χ2 test and Student's t-test. Results: There was a significant difference in operation time (275.3 vs. 228.9 minutes, p < 0.01) between the learning and mature groups. Perioperative variables (lymph node dissection method, nipple preservation, and reconstruction method) were also analyzed, but there were no demographic differences between the groups. The complication rate was higher in the learning group, although this difference was also not statistically significant. Conclusion: Our study is the first to discuss the learning curve of endoscopic total mastectomy. The operation time decreased significantly after 15 cases at each hospital. Although the operation is still more time-consuming than traditional methods, it has the benefit of smaller wounds and improved cosmetic outcomes if combined with immediate reconstruction.

AB - Introduction: Laparoscopic techniques are commonly used in abdominal and gynecologic surgery, while breast cancer surgery has remained largely unchanged. In Asia, especially in Japan, many surgeons have started to use endoscopic surgery for breast cancer. In Taiwan, endoscopy-assisted breast surgery started in 2010. The benefits of this surgical method include smaller incisions, an axillary anatomic approach, clear vision, no oncologic compromise, and good cosmetic outcomes. This is the first report to discuss the learning curve of endoscopy-assisted breast surgery, including the difficulties experienced. Materials and methods: From June 2011 to December 2013, data were collected from 134 patients who received an endoscopic total mastectomy at the Taipei Medical University Hospital (TMUH) or Changhua Christian Hospital (CCH). We divided these patients into a learning group (TMUH, n = 15; CCH, n = 15) and a mature group (TMUH, n = 50; CCH, n = 54). Patient data and perioperative variables were recorded by retrospective chart review. Variables were compared using the χ2 test and Student's t-test. Results: There was a significant difference in operation time (275.3 vs. 228.9 minutes, p < 0.01) between the learning and mature groups. Perioperative variables (lymph node dissection method, nipple preservation, and reconstruction method) were also analyzed, but there were no demographic differences between the groups. The complication rate was higher in the learning group, although this difference was also not statistically significant. Conclusion: Our study is the first to discuss the learning curve of endoscopic total mastectomy. The operation time decreased significantly after 15 cases at each hospital. Although the operation is still more time-consuming than traditional methods, it has the benefit of smaller wounds and improved cosmetic outcomes if combined with immediate reconstruction.

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