达芬奇机器人手术系统在宫颈癌广泛子宫切除手术中学习曲线的研究  

Study on Learning Curve of Da Vinci Robotic Surgical System for Radical Hysterectomy in Cervical Cancer

作　　者：曹莉莉[1] 徐惠成[1] 陈勇[1] 潘珂[1] 梁志清[1] 

机构地区：[1]第三军医大学第一附属医院,重庆400038

出　　处：《实用妇产科杂志》2015年第9期705-708,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:评估达芬奇机器人手术系统在实施宫颈癌广泛子宫切除手术的不同阶段的手术效果,探讨腹腔镜妇科医师缩短达芬奇机器人手术系统学习曲线的要点。方法:分析2010年3月至2014年4月由同组医师完成的50例达芬奇机器人手术系统在宫颈癌广泛子宫切除手术患者的临床资料。按手术先后次序分A组(15例)、B组(15例)、C组(20例),比较各组的手术效果。结果:3组间实施保留盆腔自主神经、行腹主动脉旁淋巴结切除术例数及手术时间的比较,差异均有统计学意义(P<0.05),其中B组和C组明显优于A组,差异均有统计学意义(P<0.05);3组术后恢复自主排尿时间比较,差异有统计学意义(P<0.05),其中C组术后排尿时间最短,与A组比较,差异有统计学意义(P<0.05)。3组术中出血量、术后住院时间、盆腔淋巴结切除数、围手术期并发症发生率及手术频度的比较,差异均无统计学意义(P>0.05)。结论:有丰富腹腔镜宫颈癌手术经验的手术团队,经过30例的学习曲线,可掌握达芬奇机器人手术系统用于宫颈癌广泛子宫切除手术。Objective：To evaluate the surgical outcomes of Da Vinci robotic surgical system for radical hysterectomy in cervical cancer, and to study the key points for surgeons to shorten the learning curve quickly. Methods ： Clinical data of 50 cases which received Da Vinci robot-assisted radical hysterectomy performed by the same group of surgeons between March 2010 and April 2014 were reviewed retrospectively. The cases were divided in- to 3 groups（group A,B and C）according to the sequence of the operation. Group A with 15 cases,group B with 15 cases, and group C with 20 cases, surgery efficiency were compared. Results：There was a statistically signifi- cant difference between 3 groups in the comparison of numbers performed pelvic autonomic nerve preservation operation and para-aortic lymph node resection and the operative time, P 〈0. 05. Patients in group B and C had a significant better outcomes compared with that of group A, P 〈 0.05. The recovery time of automatic urine in group C was shorter than group A, P 〈0. 05. While no statistically significant difference was found in comparison to theblood loss, postoperative hospital stay,the number of resected lymph nodes, incidence of complications, and the frequency of operation in 3 groups. Conclusions.As for the surgeons with abundant experiences of laparoscopic surgery for cervical cancer surgery,after about 30 consecutive resections, they can overcome the learning curve and master Da Vinci robotic surgical system for radical hysterectomy in cervical cancer.

关 键 词：宫颈癌 广泛子宫切除术 学习曲线 达芬奇机器人手术系统 

分 类 号：R713.4[医药卫生—妇产科学]