文章摘要
耿良元,白剑峰,孙跃明,陆文熊,傅 赞.手术频率对腹腔镜胃癌根治术学习曲线的影响[J].南京医科大学学报,2012,(2):279~283
手术频率对腹腔镜胃癌根治术学习曲线的影响
The influence of surgical frequency on laparoscopic radical gastrectomy learning curve
投稿时间:2011-08-02  
DOI:10.7655
中文关键词: 胃癌  腹腔镜手术  手术频率  学习曲线
英文关键词: gastric cancer  laparoscopic surgery  surgical frequency  learning curve
基金项目:南京医科大学青年基金(NY99023)
作者单位
耿良元 南京医科大学第一附属医院普外科,江苏 南京 210029 
白剑峰 南京医科大学第一附属医院普外科,江苏 南京 210029 
孙跃明 南京医科大学第一附属医院普外科,江苏 南京 210029 
陆文熊 南京医科大学第一附属医院普外科,江苏 南京 210029 
傅 赞 南京医科大学第一附属医院普外科,江苏 南京 210029 
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中文摘要:
      目的:探讨手术频率对于腹腔镜胃癌根治术学习曲线的影响?方法:回顾性分析由同一组甲医师(n = 100例,月平均手术3.33例)?乙医师(n = 90例,月平均手术2.50例)分别在2008年1月~2010年6月和2008年1月~2011年1月完成的腹腔镜胃癌根治手术?按照手术先后顺序,将甲医师组分为4阶段(A?B?C?D),每阶段25例,乙医师组分为6阶段(E?F?G?H?I?J),每阶段15例?分别比较甲?乙医师组内各阶段及甲乙医师两组的手术时间?术中出血量?术后住院天数?并发症?中转开腹数?淋巴结清扫数?结果:所有分组比较的手术患者年龄?性别?病理分期?手术方式上均具有可比性?甲医师组C?D阶段手术时间及出血量显著少于A?B阶段,乙医师组I?J阶段手术时间及出血量显著少于E?F?G?H阶段,各阶段间淋巴结清扫数?并发症?术后住院天数及中转开腹率差异无统计学意义?甲医师组手术时间显著少于乙医师组手术时间,甲医师组术中出血量显著少于乙医师组术中出血量,两者差异具有统计学意义,两医师组间淋巴结清扫数?中转开腹率?手术并发症差异无统计学意义?结论:当适当增加手术频率时,可以在较短的学习曲线下,更好地掌握腹腔镜胃癌根治术?
英文摘要:
      Objective:To investigate effects of surgery frequency on the laparoscopic radical gastrectomy learning curve. Methods: A retrospective analysis of the laparoscopic radical gastrectomy by the same physician group Ⅰ and Ⅱ,respectively,from January 2008 to June 2010 (n = 100) and from January 2008 to January 2011(n = 90),the average monthly surgery rate was 3.33 and 2.50. Ⅰ group was divided into four phases (A,B,C,D),each phase of 25 cases,Ⅱgroup divided into six phases (E,F,G,H,I,J),each phase of 15 cases. Operative time,blood loss,postoperative hospital stay,complications,laparotomy number,number of lymph node dissection were compared between all groups. Results: As for four phases,the operative time and blood loss of C,D groups were significantly less than A,B phases. For six phases,the operative time and blood loss of I,J were significantly less than E,F,G,H phases,the number of lymph node dissection,complications,postoperative hospital stay and rate of transit laparotomy of each phase were not significantly different. The surgical time of 100 cases from Ⅰ group,was significantly less than 90 cases of Ⅱ group,the blood loss of patients in Ⅰ group was significantly less than the Ⅱ group,the difference of the number of lymph nodes and transit laparotomy rate and surgical complications between the two groups has no statistical significance. Conclusion: A shorter learning curve will be getten by increasing the surgery frequency appropriately,and benefit the understanding of the laparoscopic radical gastrectomy.
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