缩短腹腔镜胃肠手术学习曲线的探讨

Experience of shortening the learning curve of gastrointestinal laparoscopic operation

目的:探讨具有熟练开腹手术技术的胃肠外科医师如何缩短腹腔镜胃肠肿瘤手术的学习曲线。方法:回顾分析2009年9月至2011年8月开展的20例腹腔镜胃手术及60例腹腔镜结直肠手术的临床资料。结果:80例均成功完成腹腔镜手术,胃癌患者手术时间2.5～4h,结直肠癌患者手术时间1.5～4h,围手术期无严重并发症发生,术后1例结直肠癌患者死于胃瘫。结论:基于开腹手术的熟练解剖技术,借鉴他人腹腔镜胃肠手术经验,手术组默契协作是缩短腹腔镜胃肠手术学习曲线的关键。

Objective：To investigate how to shorten the learning curve of gastrointestinal laparoscopic surgery preformed by gastrointestinal surgeons with proficient laparotomy techniques. Methods： Related literatures were reviewed, and the clinical data of 20 eases of laparoscopie gastric operation and 60 cases of laparoscopic colorectal operation from Sep. 2009 to Aug. 2011 were retrospectively analyzed. Results：All the laparoscopic operations of 80 patients were successful.The operative time of gastric cancer was 2.5-4 h, and the operative time of colorectal cancer was 1.5-4 h. No serious complications occurred during perioperative period. 1 patient with colorectal cancer died from postoperative gastroplegia. Conclusions：Skilled anatomy technology based on open operations,lessons from otherg experience of laparoscopie operations,and cooperation of operative team are the keys of shortening the learning curve of laparoscopic gastrointestinal operation.