单孔腹腔镜胆囊切除术助手学习曲线的探讨  

Learning curve of assistants in single-incision laparoscopic cholecystectomy

作　　者：马凯[1] 侯泽斌 段亚飞 闫军[2] MA Kai;HOU Ze-bin;DUAN Ya-fei(Shansi Medical University,Taiyuan 030007,China)

机构地区：[1]山西医科大学,山西太原030001 [2]山西医科大学第一医院普通外科

出　　处：《腹腔镜外科杂志》2020年第10期761-765,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨单孔腹腔镜胆囊切除术第一助手的学习曲线。方法:回顾分析2018年至2019年由两位助手(A、B)参与完成的124例单孔腹腔镜胆囊切除术,通过移动平均线评估平均抓取时间以分析学习曲线。结果:两名助手各完成62例,两组患者的基本情况,包括性别、年龄、BMI、胆囊炎症类型、既往腹部手术史差异无统计学意义(P>0.05),手术时间、术中出血量、中转开腹率差异亦无统计学意义(P>0.05),助手A在31例、助手B在27例后平均抓取时间达到相对稳定状态。结论:单孔腹腔镜胆囊切除术第一助手具有稳定可行的学习曲线,经过约30例的手术操作后可跨越。Objective:Single-incision laparoscopic cholecystectomy(SILC)has been carried out more and more,the first assistant is an important factor affecting the difficulty of surgery.This study aimed to evaluate assistants’learning curves in SILC.Methods:A retrospective study of 124 cases of SILC performed by two assistants(A and B)in the Department of General Surgery,First Hospital of Shanxi Medical University from 2018 to 2019 was performed,and the learning curve was analyzed by average grasping time which was evaluated by moving average line.Results:Each of two assistants completed 62 operations.There were no statistical differences in the basic information of the patients,including gender,age,BMI,type of gallbladder inflammation,previous history of abdominal surgery and the surgical conditions including operation time,intraoperative blood loss,and conversion to laparotomy between the two groups.Learning curves indicated that the execution time reached a steady state after 31 cases for assistant A and 27 cases for assistant B.Conclusions:The first assistant of SILC has a stable and feasible learning curve,which can be crossed after about 30 cases of surgery.These results have implications for training assistants for SILC.

关 键 词：胆囊切除术 腹腔镜 单孔 学习曲线 第一助手 

分 类 号：R657.4[医药卫生—外科学]