以手术时间与术中出血量为参数研究经腹腹腔镜肾上腺切除术的学习曲线

The learning curve of laparoscopic adrenalectomy: measured by operation time and intraoperative blood loss

目的 以手术时间及术中出血量为参数研究经腹腹腔镜肾上腺切除术的学习曲线.方法 收集本院泌尿微创中心2012 年1 月至2014 年11 月同一组临床医师完成的135 例腹腔镜肾上腺手术患者的相关资料,按先后顺序以每组27 例分为五组.统计每组患者的手术时间及术中出血量并进行方差分析,比较其组间差异.结果 通过描述统计可见,随例数增加,手术时间呈缩短趋势,术中出血量呈下降趋势.五组间,后四组手术时间有明显差异,术中出血量无明显差异,后三组差异均无显著性.结论 具有丰富开腹及腹腔镜手术经验的术者,50 ～ 60 例腹腔镜肾上腺手术是此手术的学习曲线.

Objective To evaluate the learning curve of transperitoneal laparoscopic adrenalectomy measured by operation time and intraoperative blood loss. Method The clinical data of 135 patients who were underwent laparoscopic adrenalectomy completed by the same group of surgeons from January 2012 to November 2014 were retrospectively analyzed. All the cases were divided into five groups in chronological order with each group of 27 patients. Operation time and intraoperative blood loss were analyzed and differences between groups were compared. Result By statistics, the operative time and intraoperative blood loss were decreased with the increase of cases. Among the latter four groups, the difference of operation time was significant while there was no significant difference in intraoperative blood loss parameter. Among the last three groups, there were no significant differences in both parameters. Conclusion For the urologist with rich experience of open and laparoscopic surgery, the learning curve of transperitoneal laparoscopic adrenalectomy is the accumulation 50 ~ 60 cases of experience.