Learning curve of laser vaporization for chronic hemorrhoids

Abstract

AIM: to assess the learning curve of implementation of laser vaporization for hemorrhoids.PATIENTS AND METHODS: laser vaporization was performed by one surgeon for 378 patients, which had no personal experience of implementation of this technique before. CUSUM method was used to analyze the duration of the training period.RESULTS: the two-fold decrease of negative results percentage was obtained after 40 procedures. During the training period, 7 (17.5%) unfavorable outcomes were revealed and 17 (5.0%) — during consolidation of experience (p = 0.008). Difference in outcomes between vaporizations only and combined interventions was not significant.CONCLUSION: the learning curve for implementation of laser vaporization for hemorrhoids determined by the СUSUM analysis method is 40 cases. The risk of unfavorable results is not associated with the volume of procedure, but with the training period.