全胸腔镜房间隔室间隔缺损修补手术学习曲线

The learning curve of thoracocopic technology for atrial septai defect and ventrical septai defect repair

目的总结全胸腔镜下心脏手术的学习曲线。方法回顾性收集2004年10月至2010年1月由同一术者连续完成的125例全胸腔镜下房间隔缺损、室间隔缺损修补手术病例资料，按手术先后顺序分为A、B、C、D、E5组，每组25例，从各组手术时间、体外循环时间、主动脉阻断时间、中转开胸率及手术并发症等指标比较手术效果。结果各组病例年龄、性别、体重、病种及手术方式差异无统计学意义（P〉0．05）。手术时间、体外循环时间、主动脉阻断时间3项指标A、B组明显长于C、D、E组（P〈0．05），A、B两组间差异无统计学意义（P〉0．05），C、D、E3组之间差异亦无统计学意义（P〉0．05）。各组中转开胸率及手术并发症发生率比较差异均无统计学意义（P〉0．05）。结论全胸腔镜房间隔、室间隔缺损修补术的学习曲线约为50例。

Objective To investigate the learning curve of total thoracoscopicy cardiac surgery. Methods Clinical data of a succession of 125 patients undering total thoracoscopicy ASD and VSD repair between October 2004 to January 2010 were collected and reviewed. The procedure was perfomed by the same surgeon. The patients were divided equally into 5 groups （ groupA, B, C, D and E, n = 25 in each group ） according to the sequence of the operation. The operative time, extracorporeal circulation time, aortic cross-clamped time, the rate of conversion rate to thoracotomy and postoperative complications were compared between the 5 groups. Results There were no statistically significant differences between the 5 groups with respect to age, gender, weight, dieases and surgical approach（ P 〉 0.05 ）. The operative time, extracorporeal circulation time and aor- tic clump time in group A and group B significant longer then that in group C, group D and group E （ P 〈 0. 05 ）. Group A and group B was no statistically significant difference each other（ P 〉 0.05 ）. Group C, D and E have no statistically significant differences between （ P 〉 0.05 ）. The rate of conversion rate to thoracotomy and postoperative complications in 5 groups have no statistically significant differences comparative（P 〉 0.05 ）. Conclusion The learning curve of total thoracoscopicy surgery is approximalely 50 cases.