腹腔镜结直肠手术学习曲线的分析

Study on learning curve of laparoscopic colorectal surgery

目的:探讨腹腔镜结直肠手术的学习曲线。方法:回顾分析2006年1月至2011年12月为120例患者行腹腔镜结直肠手术的临床资料,按手术先后次序分为6组(n=20),每20例为一学习曲线阶段,对比分析各阶段的手术时间、手术频度、并发症发生率、中转开腹率及术后住院时间等。结果:6组患者在手术方式、并发症发生率及中转开腹率等方面差异无统计学意义,但手术时间、手术频度及术后住院时间6组相比差异有统计学意义。结论:腹腔镜结直肠手术约40例后,手术技术即可达到较熟练的状态,但除手术例数外,手术频度也是重要的影响因素。

Objective：To investigate the learning curve of laparoscopic eoloreetal surgery. Methods： Clinical data of 120 cases which received laparoscopic colorectal surgery from Jan. 2006 to Dec. 2011 were analyzed retrospectively. The patients were divided into 6 groups （ n ： 20） according to the sequence of the operation and every 20 cases was a learning phase. The operating time, frequency of operation,complication rate,conversion rate to open surgery and hospital stay were compared among the 6 phases. Results：No signifi- cant differences in the surgical procedures,complication rate and conversion rate to open surgery were found among 6 groups However, there were significant differences in the operating time, frequency of operation and hospital stay among all groups. Conclusions：The learning curve was approximately 50 cases＇ practice for mastering the laparoscopic colorectal surgery skills. Apart from the amounts of operation, the frequency of operation is also an important factor.