CAJ | 학술논문

目的：通过比较同一术者腹腔镜下宫颈癌根治术（广泛性子宫切除术联合盆腔淋巴结清扫术）不同阶段的手术结果，探讨其学习曲线。方法回顾性分析解放军第一五二中心医院妇产科2007年1月至2009年5月接收腹腔镜下宫颈癌根治术的早期宫颈癌患者120例。以手术先后顺序，分别以每30例和每40例为一学习曲线阶段，将所有病例分为4阶段和3阶段两种比较方式，分别比较各阶段在手术时间、术中出血量、术中并发症、淋巴结检出数目及术后住院时间等方面的差异，同时分析两种比较方式第1阶段除外，其余阶段间的差异。结果各阶段手术病例在淋巴结检出数目、术后住院时间等方面，差异均无统计学意义。两种比较方式第1阶段的手术时间、术中出血量、术中并发症均与其余各阶段比较，差异有统计学意义，仅第2种比较方式的手术时间、术中出血量、术中并发症在其余各阶段比较，差异无统计学意义。结论腹腔镜下宫颈癌根治手术经过30～40例手术操作可达较熟练和稳定程度。
목적：통과비교동일술자복강경하궁경암근치술（엄범성자궁절제술연합분강림파결청소술）불동계단적수술결과，탐토기학습곡선。방법회고성분석해방군제일오이중심의원부산과2007년1월지2009년5월접수복강경하궁경암근치술적조기궁경암환자120례。이수술선후순서，분별이매30례화매40례위일학습곡선계단，장소유병례분위4계단화3계단량충비교방식，분별비교각계단재수술시간、술중출혈량、술중병발증、림파결검출수목급술후주원시간등방면적차이，동시분석량충비교방식제1계단제외，기여계단간적차이。결과각계단수술병례재림파결검출수목、술후주원시간등방면，차이균무통계학의의。량충비교방식제1계단적수술시간、술중출혈량、술중병발증균여기여각계단비교，차이유통계학의의，부제2충비교방식적수술시간、술중출혈량、술중병발증재기여각계단비교，차이무통계학의의。결론복강경하궁경암근치수술경과30～40례수술조작가체교숙련화은정정도。
Objective To investigate the learning curve of laparoscopia radical hysterectomy and lymph node dissection in cervical cancer and to compare the surgical pathologic outcomes of cases treated at different stages.Methods A total of 120 surgical cases of laparoscopic radical hysterectomy and pelvic lymphadenectomy for cervical cancer performed by a group of surgeons were reviewed from Jan.2007 to May.2009.Different standards were used to divided them into 4 stages (group 1 ∶30 cases in each)and 3 stages (group 2∶40 cases in each)respectively by operative sequences.The operating time,the blood loss,the incidences of intraoperative and postoperative complications,the number of revealed lymph nodes and the length of postoperative hospital stay were analyzed simultaneously.Results There was no significant differences among the 4 stages and 3 stages with the respect to the number of revealed lymph nodes and the length of postoperative hospital stay.There were significant differences with respect to the operating time,the blood loss,the incidences of intraoperative and postoperative complications between the first stage and the remainder of stages of two groups.However,There were no significant differences with respect to the operating time,the blood loss,the incidences of intraoperative and postoperative complications in the remainder of stages of group 2.Conclusions A surgeon may become experienced in laparoscopic radical hysterectomy and lymph node dissection by operating 30-40 patients with cervical cancer.