La Clinica Terapeutica
Learning Curve in Thoracoscopic Mediastinal Mass Excision: A Multicenter Retrospective Cohort Study Using Cumulative Sum and Multivariable Regression Analysis: doi: 10.7417/CT.2026.2165
By Elsayed , Khaled, Ibrahim, Gamil K., Elghanam, Mohamed and 11 others.
Abstract
Background
Video-assisted thoracoscopic surgery (VATS) mediastinal mass excision has become the standard approach for anterior mediastinal lesions. Understanding its learning curve is essential for surgical training and quality assurance. This study evaluated the learning curve of thoracoscopic mediastinal mass excision and estimated the number of cases required to achieve surgical proficiency.
Methods
This multicenter retrospective cohort study was conducted at five academic and tertiary-care centers in Egypt and Saudi Arabia between January 2023 and December 2025. Seventy-seven consecutive patients undergoing VATS excision of mediastinal masses were categorized into three phases: Early (first 20 cases), Intermediate (next 20 cases), and Late (last 37 cases). Cumulative sum (CUSUM) analysis was performed. Operative outcomes, including operative time, blood loss, conversion rate, and postoperative complications, were compared across phases.