Prospective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine model
Abstract Background As a relatively new surgical technique, the learning curve of en bloc resection of bladder tumor (ERBT) in ex vivo models remains unaddressed. This study aimed to explore the learning curve of ERBT in an ex vivo porcine model. Methods In this prospective study, eight endoscopists...
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BMC
2024-02-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-024-02355-w |
| _version_ | 1797276066309472256 |
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| author | Qiu Yao Huizhong Jiang Hui Niu Guangmo Hu Xiaolong Liu Boxin Xue |
| author_facet | Qiu Yao Huizhong Jiang Hui Niu Guangmo Hu Xiaolong Liu Boxin Xue |
| author_sort | Qiu Yao |
| collection | DOAJ |
| description | Abstract Background As a relatively new surgical technique, the learning curve of en bloc resection of bladder tumor (ERBT) in ex vivo models remains unaddressed. This study aimed to explore the learning curve of ERBT in an ex vivo porcine model. Methods In this prospective study, eight endoscopists without prior experience in ERBT were divided into two groups: junior endoscopists, with less than 100 transurethral resection of bladder tumor (TURBT) procedure experience, and senior endoscopists, with at least 100 TURBT procedure experience. Each endoscopist performed 30 ERBT procedures on artificial lesions in an ex vivo porcine bladder model. The procedure time, perforation, en bloc resection status, and absence of detrusor muscle (DM) were recorded. The inflection points were identified using cumulative sum (CUSUM) analysis. Procedure results were compared between the two phases and two groups. Results In all, 240 artificial lesions were successfully resected using ERBT. The CUSUM regression line indicated the inflection point at the 16th procedure for the junior endoscopists and at the 13th procedure for the senior endoscopists. In both groups, the procedure time, perforation, piecemeal resection, and DM absence rates were significantly lower in the consolidation phase than in the initial phase. The procedure time for the senior endoscopists was lower than for the junior endoscopists in both phases. Conclusions ERBT performance improved significantly after reaching the inflection point of the learning curve in the ex vivo model. We recommend a minimum of 16 ERBT procedures in ex vivo models for urologists with less than 100 TURBT experience and a minimum of 13 procedures for those with at least 100 TURBT experience before advancing to live animal training or supervised clinical practice. |
| first_indexed | 2024-03-07T15:22:59Z |
| format | Article |
| id | doaj.art-7da6dbb0164f44d0a7cb4a8bd2514a63 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-07T15:22:59Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-7da6dbb0164f44d0a7cb4a8bd2514a632024-03-05T17:30:43ZengBMCBMC Surgery1471-24822024-02-012411910.1186/s12893-024-02355-wProspective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine modelQiu Yao0Huizhong Jiang1Hui Niu2Guangmo Hu3Xiaolong Liu4Boxin Xue5Department of Urology, The Second Affiliated Hospital of Soochow UniversityDepartment of Operating Room, The Second Affiliated Hospital of Soochow UniversityDepartment of Pathology, The Second Affiliated Hospital of Soochow UniversityDepartment of Urology, The Second Affiliated Hospital of Soochow UniversityDepartment of Urology, The Second Affiliated Hospital of Soochow UniversityDepartment of Urology, The Second Affiliated Hospital of Soochow UniversityAbstract Background As a relatively new surgical technique, the learning curve of en bloc resection of bladder tumor (ERBT) in ex vivo models remains unaddressed. This study aimed to explore the learning curve of ERBT in an ex vivo porcine model. Methods In this prospective study, eight endoscopists without prior experience in ERBT were divided into two groups: junior endoscopists, with less than 100 transurethral resection of bladder tumor (TURBT) procedure experience, and senior endoscopists, with at least 100 TURBT procedure experience. Each endoscopist performed 30 ERBT procedures on artificial lesions in an ex vivo porcine bladder model. The procedure time, perforation, en bloc resection status, and absence of detrusor muscle (DM) were recorded. The inflection points were identified using cumulative sum (CUSUM) analysis. Procedure results were compared between the two phases and two groups. Results In all, 240 artificial lesions were successfully resected using ERBT. The CUSUM regression line indicated the inflection point at the 16th procedure for the junior endoscopists and at the 13th procedure for the senior endoscopists. In both groups, the procedure time, perforation, piecemeal resection, and DM absence rates were significantly lower in the consolidation phase than in the initial phase. The procedure time for the senior endoscopists was lower than for the junior endoscopists in both phases. Conclusions ERBT performance improved significantly after reaching the inflection point of the learning curve in the ex vivo model. We recommend a minimum of 16 ERBT procedures in ex vivo models for urologists with less than 100 TURBT experience and a minimum of 13 procedures for those with at least 100 TURBT experience before advancing to live animal training or supervised clinical practice.https://doi.org/10.1186/s12893-024-02355-wEx vivo modelNon–muscle-invasive bladder cancerEn bloc resection of bladder tumorLearning curveCumulative sum analysis |
| spellingShingle | Qiu Yao Huizhong Jiang Hui Niu Guangmo Hu Xiaolong Liu Boxin Xue Prospective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine model BMC Surgery Ex vivo model Non–muscle-invasive bladder cancer En bloc resection of bladder tumor Learning curve Cumulative sum analysis |
| title | Prospective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine model |
| title_full | Prospective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine model |
| title_fullStr | Prospective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine model |
| title_full_unstemmed | Prospective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine model |
| title_short | Prospective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine model |
| title_sort | prospective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine model |
| topic | Ex vivo model Non–muscle-invasive bladder cancer En bloc resection of bladder tumor Learning curve Cumulative sum analysis |
| url | https://doi.org/10.1186/s12893-024-02355-w |
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