摘要
目的探讨腹腔镜辅助胃癌根治术的学习曲线。方法回顾性分析2007年1月至2008年11月我科开展腹腔镜辅助胃癌根治术以来150例患者的临床资料,按手术先后顺序分3组(A、B、C组),每组50例,对各组患者的手术时间、术中出血量、中转开腹率、淋巴结清扫数目、术后肛门排气时间、术后住院天数和术后并发症发生率等进行比较。结果三组患者年龄、性别构成比、术前体重指数、既往腹部手术史、术前合并症以及肿瘤部位、术前分期、手术方式、清扫方式比较,差异均无统计学意义(P>0.05)。手术时间和术中出血量B、C组均比A组减少,差异有统计学意义(P<0.05),B、C组间差异无统计学意义(P>0.05)。中转开腹率A组为18.0%,B组4.0%,C组2.0%,三组间差异均有统计学意义(P<0.05)。淋巴结清扫数目B、C组比A组增多,差异有统计学意义(P<0.05),B、C组之间差异无统计学意义(P>0.05)。患者术后肛门排气时间和术后住院时间B、C组比A组显著减少,差异有统计学意义(P<0.05),B、C组间差异无统计学意义(P>0.05)。三组间患者术后并发症发生率差异无统计学意义(P>0.05)。结论腹腔镜辅助胃癌根治术的学习曲线大约为50例,此后手术操作可达到较为熟练的程度。
Objective To investigate the learning curve of laparoscopy-assisted radical gastrectomy(LARG) for gastric cancer.Methods Clinical data of first 150 gastric cancer patients undergoing LARG from January 2007 to November 2008 in our department were analyzed retrospectively.The patients were divided into three groups(group A,B and C) with 50 cases in each group,according to the sequence of operation.The operating time,blood loss,conversion rate to open surgery,the number of lymph nodes resected,postoperative time to recovery of bowel function,hospital stay,postoperative complications were compared among the three groups.Results There were no significant differences in age,sex,pre-operative body mass index(BMI),previous history of abdominal operation,coexistent diseases,tumor locations,pre-operative TNM stages,resection types of the stomach,extents of lymphadenectomy among the three groups(P>0.05).The operating time and blood loss decreased significantly in group B and C than those in group A(P<0.05),but there were no significant differences between group B and C(P>0.05).The conversion rate to open surgery was 18.0%(9/50) in group A,4.0% in group B and 2.0% in group C,there was significant difference among the three groups(P<0.05).The number of lymph nodes resected increased significantly in group B and C than those in group A(P<0.05),while there was no significant difference between group B and C(PP>0.05).The time to recovery of bowel function and hospital stay decreased significantly in group B and C than those in group A(P<0.05),but there were no significant differences between group B and C(P>0.05).There were no significant differences in postoperative complications among the three groups(P>0.05).Conclusions As for the surgeons with abundant experiences of open radical resection for gastric cancer,after a learning curve of 50 laparoscopy-assisted radical resections for gastric cancer,they can overcome the learning curve and master the surgical skills proficiently.
出处
《消化肿瘤杂志（电子版）》
2011年第3期151-155,共5页
Journal of Digestive Oncology(Electronic Version)
