摘要
目的探讨腹腔镜直肠低位前切除术(Dixon手术)的学习曲线。方法回顾分析2001年11月—2002年12月我院80例腹腔镜Dixon手术病人的临床资料,按手术先后次序分为A、B、C、D组,每组20例,比较各组的手术时间、术中出血量、淋巴结清扫数、中转开腹率和并发症,分析不同阶段的手术效果。结果各组病例在年龄、性别、病理分期、病灶位置和手术方式等方面差异无显著性(P>0.05)。A、B组的手术时间明显长于C、D组(F=10.25,q=3.49～6.89,P<0.05),A组与B组、C组与D组之间差异无显著性(P>0.05)。A、B组术中出血量明显多于C、D组(F=13.40,q=4.98～11.18,P<0.01),而A组与B组、C组与D组差异也有显著性(q=3.24、2.96,P<0.05)。中转开腹率由A、B组的30%(6/20)和25%(5/20)降至C、D组的10%(2/20)和5%(1/20)。各组淋巴结清扫数和并发症差异无显著性(P>0.05)。A组手术在4个月内完成,每月平均5.0例;B组每月平均5.7例;C组平均每月6.6例;D组平均每月10.0例。结论腹腔镜Dixon手术的学习曲线大致为40例,手术频度为平均每月5.3例。
Objective To investigate the learning curve for laparoscopic lower anterior resection of rectum （Dixon opera- tion）. Methods Clinical data of 80 cases of laparoscopic Dixon operation done between November 2001 and December 2002 were retrospectively analyzed. They were equally divided into four groups （groups A, 13, C and D） according to the order of early or late by time. A comparison among the four groups was conducted in terms of operation time, blood loss at surgery, number of lymph nodes removed, rate of conversion to open surgery and complications. The efficacy of surgery was analyzed as well. Results There were no significant difference among the four groups with regard to age, sex, TNM stage, location of the focus and surgical procedures （P〈0.05）. The operation time in groups A and B were significantly longer than that in groups C and D （F = 10.25; q=3.49-6.89;P〈0.05）, but the time between groups A and B, C and D was not significantly different. The blood loss at sur- gery in groups A and B was much more than that in groups C and D （F=13.40;q=4.98-11.18;P〈0.01）, and the differences between groups A and B, and C and D were also significant （q=3. 24,2. 96 ;P〈0.05）. The rate of conversion to open surgery was from 30% （6/20） and 25% （5/20） in groups A and B, respectively, lowered to 10%（2/20） and 5%（1/20） in groups C and D. No significant differences among the four groups with regard to the number of the lymph node removal and complications （P〉0.05）. In group A,the 20 cases were done within 4 months （5.0 cases/month）; in group B,5.7 cases/month; in group C, 6.6 cases/ month, and in group D, 10.0 cases/month. Conclusion The leaning curve of laparoscopic Dixon operation is roughly 40 cases, with an average monthly frequency being 5.3 cases.
出处
《青岛大学医学院学报》
CAS
2013年第1期19-21,共3页
Acta Academiae Medicinae Qingdao Universitatis
关键词
直肠肿瘤
腹腔镜检查
学习曲线
rectal neoplasms~ laparoscopy~ learning curve
作者简介
孙振青（1972-），男，硕士，副主任医师。
