CAJ | 학술논문

目的：探讨有丰富腹腔镜及开放甲状腺手术经验者行腔镜甲状腺切除术的学习曲线。方法回顾性分析2011年6月~2013年4月由同组医师完成的75例经乳晕入路腔镜下甲状腺切除术的临床资料。按手术先后次序分别纳入A、B、C组,每组25例,比较各组的手术频数、手术时间、出血量、中转开放率、引流管引流量、并发症、住院天数。结果 A组手术频数为2.5例/月,B组为3.5例/月,C组为5例/月。3组病例在年龄、性别、肿块大小和手术方式等方面有可比性。 A组的手术时间显著长于B组和C组(P<0.05)；A组的出血量显著多于B组和C组(P<0.05)。 A组的引流量均显著多于B组和C组(P<0.05)。三组中转开放率、并发症发生率及住院天数差异无显著性(P>0.05)。结论拥有丰富腹腔镜手术及开放甲状腺手术经验者行腔镜甲状腺切除术的学习曲线大致为25例左右。
목적：탐토유봉부복강경급개방갑상선수술경험자행강경갑상선절제술적학습곡선。방법회고성분석2011년6월~2013년4월유동조의사완성적75례경유훈입로강경하갑상선절제술적림상자료。안수술선후차서분별납입A、B、C조,매조25례,비교각조적수술빈수、수술시간、출혈량、중전개방솔、인류관인류량、병발증、주원천수。결과 A조수술빈수위2.5례/월,B조위3.5례/월,C조위5례/월。3조병례재년령、성별、종괴대소화수술방식등방면유가비성。 A조적수술시간현저장우B조화C조(P<0.05)；A조적출혈량현저다우B조화C조(P<0.05)。 A조적인류량균현저다우B조화C조(P<0.05)。삼조중전개방솔、병발증발생솔급주원천수차이무현저성(P>0.05)。결론옹유봉부복강경수술급개방갑상선수술경험자행강경갑상선절제술적학습곡선대치위25례좌우。
Objective To analyze the learning curve for an experienced laparoscopy and open thyroidectomy surgeon in performing endoscopic thyroidectomy by areola approach. Methods Retrospectively analyzed from June 2011 to April 2013,the 75 cases with thyroid neoplasms underwent endoscopic thyroidectomy done at the same team by areola approach were divided into three groups(n=25)based on the surgery date. The clinical datas were including the operative frequency, the mean operating time,the mean blood loss,conversion to open surgery,the wound drainage,operative complications and the postoperative hospital stay. Results The operative frequency of group A is 2. 5/month,B is 3. 5/month and C is 5/month,No statistical differences were found among the groups in age,gender,tumor size and option of surgery. The mean op-erating time in group A was longer than the B and C groups(P<0. 05). The intraoperative mean blood loss in group A was more than the other two groups(P<0. 05),and the wound drainage has the same result. The conversion to open surgery,op-erative complications and the length of postoperative hospital stay were equivalent in all groups. Conclusion For an ex-perienced laparoscopy and open thyroidectomy surgeon,the learning curve of endoscopic thyroidectomy by areola approach is about 25 cases.