达芬奇机器人辅助右半结肠癌根治术的学习曲线分析

Analysis on learning curve of Da Vinci robot-assisted radical resection of right half colon cancer

目的:分析达芬奇机器人辅助右半结肠癌根治术的学习曲线。方法:选择2016年3月至2022年6月在郑州大学第一附属医院接受达芬奇机器人辅助右半结肠癌根治术的70例患者。手术由同一组具备丰富结直肠手术经验的团队连续开展。采用累积和分析法拟合该手术的学习曲线。结果:拟合的学习曲线方程为Y=-0.003 X^(3)-0.003 X^(2)+12.849 X-130.951,R^(2)=0.771,P<0.05。第41例时曲线达到峰值,据此将学习曲线分为学习提高与稳定掌握两个阶段。与学习提高阶段相比,稳定掌握阶段手术时间缩短(P=0.005),术中出血量减少(P=0.048),术后并发症减少(P=0.039)。结论:41例为有丰富结直肠手术经验的临床医师稳定掌握达芬奇机器人辅助右半结肠癌根治术所需最小手术例数。

Aim:To analyze the learning curve of Da Vinci robot-assisted radical resection of right half colon cancer.Methods:Seventy patients who accepted Da Vinci robot-assisted radical resection of right half colon cancer in the First Affiliated Hospital of Zhengzhou University from March 2016 to June 2022 consecutively were selected.The operation was performed by the same group of experienced surgeons.CUSUM analysis was used to fit the learning curve of the operation.Results:The equation of the fitting learning curve was Y=-0.003 X^(3)-0.003 X^(2)+12.849 X-130.951,R^(2)=0.771,P<0.05.In the 41st case,the learning curve reached its peak,and the curve was allocated into 2 stages,learning stage and stable stage.Compared with the learning stage,the operative time in the stable stage was shorter(P=0.005),intraoperative blood loss was decreased(P=0.048),and postoperative complications were reduced(P=0.039).Conclusion:Forty-one cases are the minimum number for clinicians who grasp Da Vinci robot-assisted radical resection of right half colon cancer.