{"title":"Unilateral biportal endoscopic spine surgery: a meta-analysis unveiling the learning curve and clinical benefits.","authors":"Shu-Xin Liu, Rui-Song Chen, Chien-Min Chen, Li-Ru He, Shang-Wun Jhang, Guang-Xun Lin","doi":"10.3389/fsurg.2024.1405519","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To provide insights into the learning curve of unilateral biportal endoscopic (UBE) spine surgery by synthesizing available evidence on critical points and associated clinical outcomes.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple databases, yielding a pool of relevant studies. Inclusion criteria encompassed studies reporting on UBE learning curves and quantitative data related to clinical outcomes (operative time, hospital stay, and complications).</p><p><strong>Results: </strong>A total of five studies were included in the analysis, providing six datasets to elucidate the UBE learning curve. Three of the five studies analyzed learning curves using the Cumulative Sum method and identified cutoff points. One study plotted learning curves and determined cutoff points based on surgical time analysis, while the remaining one study (providing two datasets) plotted learning curves using the phased analysis method. The mean value of the cutoff point in terms of the number of cases required to reach proficiency in time to surgery was calculated at 37.5 cases, with a range spanning from 14 to 58 cases. Notably, there was a statistically significant difference in time to surgery between the late group and the early group, with the late group demonstrating a significantly reduced time to surgery (<i>P</i> < 0.0001). Additionally, the determined cutoff points exhibited significant variations when applied to patient outcome parameters, including postoperative hospitalization, postoperative drainage, and surgical complications (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>While the analysis indicates that UBE surgery's learning curve is associated with surgical time, the limited focus on this metric and potential discrepancies in cutoff point determination highlight the need for a more comprehensive understanding.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1405519"},"PeriodicalIF":1.6000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578948/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2024.1405519","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To provide insights into the learning curve of unilateral biportal endoscopic (UBE) spine surgery by synthesizing available evidence on critical points and associated clinical outcomes.
Methods: A comprehensive literature search was conducted across multiple databases, yielding a pool of relevant studies. Inclusion criteria encompassed studies reporting on UBE learning curves and quantitative data related to clinical outcomes (operative time, hospital stay, and complications).
Results: A total of five studies were included in the analysis, providing six datasets to elucidate the UBE learning curve. Three of the five studies analyzed learning curves using the Cumulative Sum method and identified cutoff points. One study plotted learning curves and determined cutoff points based on surgical time analysis, while the remaining one study (providing two datasets) plotted learning curves using the phased analysis method. The mean value of the cutoff point in terms of the number of cases required to reach proficiency in time to surgery was calculated at 37.5 cases, with a range spanning from 14 to 58 cases. Notably, there was a statistically significant difference in time to surgery between the late group and the early group, with the late group demonstrating a significantly reduced time to surgery (P < 0.0001). Additionally, the determined cutoff points exhibited significant variations when applied to patient outcome parameters, including postoperative hospitalization, postoperative drainage, and surgical complications (P < 0.05).
Conclusion: While the analysis indicates that UBE surgery's learning curve is associated with surgical time, the limited focus on this metric and potential discrepancies in cutoff point determination highlight the need for a more comprehensive understanding.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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