胸腔镜联合腹腔镜食管癌根治术学习曲线研究  

Learning Curve of Combined Laparoscopic and Thoracoscopic Esophagectomy for Esophageal Carcinoma

作　　者：许建功[1,2] 蔡瑞君[1] 王禹冰[1] 王武军[1] 

机构地区：[1]南方医科大学南方医院胸心外科,广东省广州市510515 [2]新乡医学院三附院胸心外科

出　　处：《中国全科医学》2012年第6期631-634,共4页Chinese General Practice

摘　　要：目的评估胸腔镜联合腹腔镜食管癌根治术不同阶段的手术效果,探讨开展胸腔镜联合腹腔镜食管癌根治术的学习曲线。方法回顾性分析2009年4月—2011年1月由同一组医师完成的50例胸腔镜联合腹腔镜食管癌根治术。按手术先后次序分5组(A～E组),每组10例;比较各组手术时间、术中出血量、淋巴结清扫数目、手术并发症及术后住院时间,分析不同阶段的手术效果。结果 5组患者在年龄、性别、浸润深度、肿瘤直径、清扫淋巴结数目和手术并发症等方面差异均无统计学意义(P>0.05)。手术时间A组(424±68)min、B组(348±70)min、C组(275±63)min、D组(279±64)min、E组(245±51)min,差异有统计学意义(P<0.05);术中出血量和术后住院时间5组间差异均有统计学意义(P<0.05)。结论胸腔镜联合腹腔镜食管癌根治术的学习曲线大约为20例。Objective To evaluate the surgical outcomes and to explore the learning curve of combined laparocopic and thoracoscopic esophagectomy for esophageal carcinoma. Methods 50 patients received combined laparocopic and thoraco- scopic esophagectomy performed by the same surgical team were retrospectively analyzed. The patients were divided into 5 groups （from A to E） according to surgery date. The operation time, blood loss, numbers of lymph nodes harvested, operative compli- cations, length of specimen, and hospital stay were compared between the 5 groups. Results There were no significant differ- ences between the 5 groups with respect to age, gender, blood loss, number of lymph nodes harvested and length of specimen （P〉0.05） . The operating time in group A , B, C, DandEwere （424±68） min, （348±70） min, （275±63） min, （279± 64 ） min and （ 245 ± 51 ） min respectively. The difference was statistically significant （ P 〈 0.05 ） . Statistically significant differenees were also found in blood loss and hospital stay between the 5 groups （ P 〈 0.05 ） . Conclusion The learning curve of combined laparocopie and thoraeoseopic esophagectomy for esophageal carcinoma performed is approximately 20 cases.

关 键 词：胸腔镜检查 腹腔镜检查 食管肿瘤 学习曲线 

分 类 号：R735.1[医药卫生—肿瘤]