Journal of Shandong University (Health Sciences) ›› 2026, Vol. 64 ›› Issue (7): 35-41.doi: 10.6040/j.issn.1671-7554.0.2026.0293

• Clinical Medicine • Previous Articles     Next Articles

A retrospective study of the learning curve and perioperative complications of laparoscopic radical hysterectomy for cervical cancer based on CUSUM analysis

LIANG Zhen1, YAN Xiaodong2, MA Dongmei3, ZHU Lin1   

  1. 1. Department of Gynecology, The Second Qilu Hospital of Shandong University, Jinan 250033, Shandong, China;
    2. School of Basic Medical Sciences, Shandong University, Jinan 250012, Shandong, China;
    3. Department of Reproductive Medicine, The Second Qilu Hospital of Shandong University, Jinan 250033, Shandong, China
  • Online:2026-07-10 Published:2026-07-21

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1

Abstract: Objective To investigate the impact of surgical learning curves on complications and intraoperative key indicators after laparoscopic radical hysterectomy for women with cervical cancer. and to analyze, the association between the surgical learningcurve and postoperative complications, so as to provid a theoretical reference for quality controland surgeon training. Methods A total of 102 patients who were diagnosed with early-stage cervical cancer and underwent laparoscopicradical hysterectomy were enrolled in the study. All patients were operated on by the same senior surgeon(chief physician)at the Second Qilu Hospital of Shandong University.Cumulative sum(CUSUM)analysis based on operative time was applied to model the learning curve, dividing the cases into two phases: the learning phase(the first 29 cases)and the mastery phase(the subsequent 73 cases). Intraoperative parameters and postoperative complication rates were then compared between these two phases. Results The optimal CUSUM fitting equation was CUSUMn=-117.850+89.4n-1.759n2+0.009n3(R2=0.956, P<0.05), indicating a strong model fit. Based on this model, the learning phase was attributed to the first 29 cases, while the subsequent 73 cases constituted the mastery phase. In the mastery phase, operative time and intraoperative blood loss were significantly reduced compared to the learning phase(P<0.05). However, there were no statistically significant differences between the two phases in the incidence of intraoperative or postoperative complications(including organ injury, lymphocysts, infections, and ureteral stenosis)(P>0.05). Conclusion CUSUM analysis showed that the surgeon became technically stable after performing around 29 cases. As the learning curve transitioned from the growth phase to the mastery phase, the operative efficiency improved, with shorter surgery times and reduced blood loss. Meanwhile, the rates of intraoperative and postoperative complications remained comparable.

Key words: Laparoscopic radical hysterectomy for cervical cancer, Complications, Surgical learning curve, Early-stage cervical cancer, Retrospective analysis, Cumulative sum analysis

CLC Number: 

  • R737.33
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