CAJ | 학술논문

目的探讨腹腔镜阑尾切除术手术时间变化模式和意义.方法回顾性分析2007年1月至2010年3月第三军医大学西南医院连续施行105例腹腔镜阑尾切除术患者的临床资料,剔除5例中转开腹患者,最终分析100例患者的手术情况.统计不同手术者手术时间变化情况,总结学习曲线在腹腔镜阑尾切除术中的规律.结果 3名医生成功施行腹腔镜阑尾切除术100例,手术时间为30～217 min,平均手术时间为(87±36)min.所有患者未发生手术中意外伤害,出血量＜10 ml.每位医生手术时间按病例累积呈现持续振荡下降模式,简单正弦拟合两周期点平均为9.6例,可被作为学习曲线的初步终点.结论腹腔镜阑尾切除术手术时间呈现特征性持续振荡下降模式,初步学习终点为9.6例.
목적 탐토복강경란미절제술수술시간변화모식화의의.방법 회고성분석2007년1월지2010년3월제삼군의대학서남의원련속시행105례복강경란미절제술환자적림상자료,척제5례중전개복환자,최종분석100례환자적수술정황.통계불동수술자수술시간변화정황,총결학습곡선재복강경란미절제술중적규률.결과 3명의생성공시행복강경란미절제술100례,수술시간위30～217 min,평균수술시간위(87±36)min.소유환자미발생수술중의외상해,출혈량＜10 ml.매위의생수술시간안병례루적정현지속진탕하강모식,간단정현의합량주기점평균위9.6례,가피작위학습곡선적초보종점.결론 복강경란미절제술수술시간정현특정성지속진탕하강모식,초보학습종점위9.6례.
Objective To investigate the change patterns of operation time of laparoscopic appendectomy and its significance. Methods The clinical data of 105 consecutive patients with appendicitis who received laparoscopic appendectomy at the Southwest Hospital from January 2007 to March 2010 were retrospectively analyzed. Of the 105 patients, five were converted to open surgery, and they were excluded from this study.The changes in operation time of different surgeons were statistically analyzed to detect the change patterns of the learning curve in laparoscopic appendectomy. Results A hundred cases of laparoscopic appendectomy were successfully performed by three surgeons. The mean operation time was ( 87 ± 36 ) minutes ( range, 30-217 minutes). No surgical injury happened during the operation, and the blood loss was under 10 ml. The learning curve of operation time was presented as a sine curve with an oscillating decreasing trend. The primary two cycles end at an average of 9.6 cases, which could be used as the end point of the learning curve of laparoscopic appendectomy. Conclusions The learning curve of laparoscopic appendectomy shows a typical oscillating decreasing trend. The preliminary study ends when 9.6 cases of operation are completed.