P-OGC26 Learning curves in minimally invasive esophagectomy- a systematic review and evaluation of benchmarking parameters

Abstract Background Minimally invasive techniques are increasingly used in the treatment of esophageal cancer. The learning curve for minimally oesophagectomy (MIO) is variable and can impact on patient outcomes. aim this study was to review current evidence curves MIO identify which parameters benchmarking. Methods A search major reference databases (PubMed, Medline, Cochrane) performed with no time limits up February 2020. Results were screened line Preferred Reporting Items Systematic Reviews Meta-Analyses (PRISMA) guidelines. Studies included if an assessment reported on, regardless (if any) statistical method used. Twenty-nine studies comprising 3741 patients included. Twenty-two a combination thoracoscopic, hybrid total MIO, 6 robotic assisted (RAMIE) alone 1 evaluated both RAMIE thoracoscopic esophagectomies. Operating most frequently parameter determine progression (23/39 studies), number resected lymph nodes, morbidity blood loss also Learning found plateau at 7-60 cases esophagectomy, 12-175 thoracoscopic/hybrid esophagectomy 9-85 RAMIE. Conclusions Multiple employed gauge progression. However, there validated or approved sets Further work required optimum that should be utilised ensure best outcomes length proctoring.