Analysis of the learning curve for artificial pneumothorax during an endoscopic McKeown-type resection of oesophageal carcinoma

BACKGROUND: Due to the large trauma caused by conventional open surgery, minimally invasive esophageal cancer surgery has been gradually carried out, and there is no report on the learning curve for artificial pneumothorax during an endoscopic McKeown-type resection of oesophageal carcinoma. METHODS: Forty cases of McKeown resection of oesophageal carcinoma with artificial pneumothorax that were completed by the same operator between December 2017 and August 2019 were analysed. The patients were divided into four groups (A, B, C, D) of 10 cases each according to the order of operation. The operation time, intraoperative blood loss, total lymph nodes and left recurrent laryngeal nerve lymph nodes resection, conversion rate, complication rate and hospitalization time were compared between the four groups. RESULTS: The operation time of the four groups were as follows: A, 243.2±44.1 min; B, 265.0±59.3 min; C, 255.8±41.7 min; D, 201.0±16.2 min, there were significant difference in terms of the operation time between group A, group B, group C and group D (P<0.05). Moreover, groups A and C all differed significantly from group D in the number of dissected left recurrent laryngeal nerve lymph nodes. However, no significant inter-group differences were observed in the number of trans-laparotomy and trans-thoracotomy, number of dissected total lymph nodes, intraoperative blood loss, incidence of postoperative complications and postoperative length of hospital stay (P>0.05). CONCLUSIONS: Artificial pneumothorax during an endoscopic McKeown-type resection of oesophageal carcinoma required a learning curve of approximately 30 cases.