摘要
目的探讨分析腹腔镜辅助胃癌根治手术的学习曲线及其影响因素。方法回顾性分析2007年至2011年62例腹腔镜辅助胃癌根治手术患者的临床资料,根据手术日期先后顺序分为初期A、后期B两组;其中远端胃癌根治术45例,根据手术日期先后顺序分为初期Da、后期Db两组。分别比较初期与后期手术的手术情况。结果 62例腹腔镜辅助胃癌根治手术,初期与后期两组在术中出血、术后引流量、排气时间、进流食时间、术后住院时间、并发症发生率及淋巴结清扫总数方面无显著性差异,初期A组患者平均手术时间(233.07±46.62)min,显著长于B组(209.24±50.15)min(P<0.05)。45例远端胃癌根治术患者中,初期Da组平均手术时间(234.7±45.32)min,术中出血量(111.3±40.63)ml,显著高于后期Db组的(198.2±40.57)min、(89.5±36.42)ml(P<0.05)。结论腹腔镜胃癌根治手术开展的不同阶段在手术时间及术中出血等方面体现出学习曲线特征。不同手术方式及不同手术团队具有不同学习曲线的规律。
Objective To evaluate the learning curve of laparoscopy-assisted radical gastrectomy for gastric cancer,and analyze its influencing factors.Methods Clinical data of 62 gastric cancer patients undergoing laparoscopy-assisted radical gastrectomy from March 2007 to August 2011 were retrospectively analyzed.According to the sequence of operation time,62 patients were divided into early A and later B groups with 31 cases in each group.Forty-five patients undergoing distal subtotal gastrectomy were also divided into early Da(n=22) and later Db(n=23) groups.Peri-operative especially operative indexes were compared between the early and later groups.Results There were no significant differences in intra-operative blood loss,post-operative drainage volume,time to recovery of flatus passage,time to liquid diet,hospital stay,complication rate and number of lymph node harvested between the early A and later B groups from 62 cases undergoing laparoscopy-assisted radical resection.The operative time was(233.07±46.62)min in early A group,significantly longer than(209.24±50.15)min in later B group(P<0.05).Of the 45 cases undergoing distal gastrectomy,the operating time and blood loss were(234.7±45.32)min and(111.3±40.63)ml respectively in early Da group,significantly more than(198.2±40.57)min and(89.5±36.42)ml in later Db group(P<0.05),but there were no differences in other operative indexes between the two group.Conclusions Laparoscopy-assisted radical gastrectomy shows different learning curves in terms of operating time and blood loss in different periods.Different resection types and surgeon groups have different learning curves.
出处
《消化肿瘤杂志（电子版）》
2011年第3期156-159,共4页
Journal of Digestive Oncology(Electronic Version)
关键词
胃癌
根治切除
腹腔镜手术
学习曲线
Gastric cancer
Laparoscopy
Radical gastrectomy
Learning curve
