Learning Curve for Metastatic Liver Tumor Open Resection in Patients with Primary Colorectal Cancer: Use of the Cumulative Sum Method

Bartlomiej Banas, Piotr Gwizdak, Paulina Zabielska, Piotr Kolodziejczyk and Piotr Richter
Additional contact information
Bartlomiej Banas: First Department of Surgery, Jagiellonian University Medical College, 30-688 Kraków, Poland
Piotr Gwizdak: First Department of Surgery, Jagiellonian University Medical College, 30-688 Kraków, Poland
Paulina Zabielska: Sub-Department of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University, 71-210 Szczecin, Poland
Piotr Kolodziejczyk: First Department of Surgery, Jagiellonian University Medical College, 30-688 Kraków, Poland
Piotr Richter: First Department of Surgery, Jagiellonian University Medical College, 30-688 Kraków, Poland

IJERPH, 2022, vol. 19, issue 3, 1-9

Abstract: Background: Liver resections have become the first-line treatment for primary and metastatic tumors and, therefore, are considered a core aspect of surgical training. This study aims to evaluate the learning curve of the extent and safety of liver resection procedures for patients with metastatic colorectal cancer. Methods: This single tertiary center retrospective analysis includes 158 consecutive cases of small liver resection (SLR) (n = 107) and major liver resection (MLR) (n = 58) procedures. A cumulative sum control chart (CUSUM) method was used to investigate the learning curve. Results: The operative time, total blood loss level, and incidence of adverse effects showed a learning curve. For SLRs, the CUSUM curve for operative time and blood loss level peaked at the 19th and 17th case, respectively, while for MLRs, these curves peaked at the 28th and 24th case, respectively. The CUSUM curve for minor adverse effects (MAEs) and severe adverse effects (SAEs) showed a downward slope after the 16th and 68th procedures in the SLRs group and after the 29th and 39th procedures in the MLRs cohort; however, it remained within the acceptable range throughout the entire study. Conclusion: SLR procedures were performed faster with less intraoperative blood loss and shorter postoperative stays than MLRs, and a higher number of completed procedures was required to gain stabilization and repeatability in the operating time and intraoperative blood loss level. In MLR procedures, the reduction of SAEs was accomplished significantly later than the stabilization of the operative time and intraoperative blood loss level.

Keywords: learning curve; major liver resections; metastatic liver tumor; small liver resections (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/3/1068/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/3/1068/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:3:p:1068-:d:727939

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().