摘要
目的通过比较同一术者腹腔镜下宫颈癌根治术(广泛性子宫切除术联合盆腔淋巴结清扫术)不同阶段的手术结果,探讨其学习曲线。方法回顾性分析解放军第一五二中心医院妇产科2007年1月至2009年5月接收腹腔镜下宫颈癌根治术的早期宫颈癌患者120例。以手术先后顺序,分别以每30例和每40例为一学习曲线阶段,将所有病例分为4阶段和3阶段两种比较方式,分别比较各阶段在手术时间、术中出血量、术中并发症、淋巴结检出数目及术后住院时间等方面的差异,同时分析两种比较方式第1阶段除外,其余阶段间的差异。结果各阶段手术病例在淋巴结检出数目、术后住院时间等方面,差异均无统计学意义。两种比较方式第1阶段的手术时间、术中出血量、术中并发症均与其余各阶段比较,差异有统计学意义,仅第2种比较方式的手术时间、术中出血量、术中并发症在其余各阶段比较,差异无统计学意义。结论腹腔镜下宫颈癌根治手术经过30;0例手术操作可达较熟练和稳定程度。
Objective To investigate the learning curve of laparoscopia radical hysterectomy and lymph node dissection in cervical cancer and to compare the surgical pathologic outcomes of cases treated at different stages.Methods A total of 120 surgical cases of laparoscopic radical hysterectomy and pelvic lymphadenectomy for cervical cancer performed by a group of surgeons were reviewed from Jan.2007 to May.2009.Different standards were used to divided them into 4 stages(group 1∶30 cases in each)and3 stages(group 2∶40 cases in each)respectively by operative sequences.The operating time,the blood loss,the incidences of intraoperative and postoperative complications,the number of revealed lymph nodes and the length of postoperative hospital stay were analyzed simultaneously.Results There was no significant differences among the 4 stages and 3 stages with the respect to the number of revealed lymph nodes and the length of postoperative hospital stay.There were significant differences with respect to the operating time,the blood loss,the incidences of intraoperative and postoperative complications between the first stage and the remainder of stages of two groups.However,There were no significant differences with respect to the operating time,the blood loss,the incidences of intraoperative and postoperative complications in the remainder of stages of group 2.Conclusions A surgeon may become experienced in laparoscopic radical hysterectomy and lymph node dissection by operating 30-40 patients with cervical cancer.
作者
申沛
朱前勇
郭伟平
赵洪伟
朱芳芳
林耀蕙
Shen Pei;Zhu Qianyong;Guo Weiping;Zhao Hongwei;Zhu Fangfang;Lin Yaohui(Department of Obstetrics and Gynecology,The 152 Central Hospital of PLA,Pingdingshan,Pingdingshan 467000,China;Department of Obstetrics and Gynecology,The 153 Central Hospital of PLA,Zhengzhou 450000,China)
出处
《中华腔镜外科杂志(电子版)》
2015年第2期132-135,共4页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
全军“十二五”医学科技基金资助项目(CWS11J014)
平顶山市科技攻关计划项目(2011057)
作者简介
通讯作者:申沛(1982-),主治医师,主要从事妇科肿瘤微创手术的研究,Email:shenpei122@163.com
