[Evaluation of experience acquisition in video-assisted hemithyroidectomy].

Objective: To determine validity and adequacy of the assessment of experience acquisition in video-assisted hemithyroidectomy, to compare surgical outcomes at the learning stage and in delayed period.

Material And Methods: Experience acquisition was studied via assessment of the duration of video-assisted hemithyroidectomy in 67 patients who were operated by the same surgeon. Time of surgery was analyzed through between-group comparison of surgical outcomes. These groups were defined arbitrarily, in exponential fashion, using the logarithm method and moving average. Risks of failure regarding duration of surgery and postoperative complications were investigated using CUSUM analysis.

Results: Minimum period of experience accumulation in video-assisted hemithyroidectomy (26 procedures) was determined using logarithmic analysis, maximum period (66 interventions) - using CUSUM analysis. Other approaches also showed sharp nature of the learning curve.CUSUM analysis of failures at the learning stage showed 2-fold decrease of their probability after 66 operations. However, even experience acquisitiondoes not exclude risk of failures in hemithyroidectomy.

Conclusion: Arbitrary division of the cohort of patients seems to be unreasonable because clear number of operations necessary to achieve sustainable results does not follow it.Mathematical methods adequately reflect experience accumulation and allow determining the required number of interventions for stable results and minimum complication rate.