腹腔镜经腹腹膜前疝修补术治疗腹股沟疝的学习曲线分析  

Analysis of the learning curve of laparoscopic transabdominal preperitoneal prosthesis for treating inguinal hernia

作　　者：郑磊 徐茂奇[1] 汪晋[1] 丰茂坤 江雯 张正林[1] 郑海峰 芮景 ZHENG Lei(The third ward of general surgery,Wuhu Traditional Chinese Medicine hospital,Anhui College of Traditional Chinese Medicine,Wuhu,Anhui,241000,China)

机构地区：[1]安徽中医药高等专科学校附属芜湖市中医医院外三科,安徽芜湖241000

出　　处：《齐齐哈尔医学院学报》2021年第1期24-27,共4页Journal of Qiqihar Medical University

基　　金：通信作者:郑磊,Email:[e-mail]。

摘　　要：目的探讨腹腔镜下经腹腹膜前疝修补术(TAPP)不同手术步骤的学习曲线。方法选取2017年11月—2020年4月本院收治的由同组医师开展的92例TAPP手术患者的临床资料。将手术分割为2个主要步骤,分别为分离腹膜阶段和缝合腹膜阶段,按手术日期先后,记录手术时间及各阶段的完成时间,采用移动加权平均法、累积和法借助SPSS软件得到学习曲线。根据学习曲线所得结果分为2个阶段,分别为每个阶段的手术时间、出血量、住院时间及术后近期并发症情况等数据进行统计学分析。结果分离腹膜及放置补片的曲线时间截点类似,缝合腹膜的学习曲线与另外2个步骤有所不同。不用阶段之间病例一般情况、术后近期并发症发生率、出血量及住院时间比较,差异无统计学意义(P>0.05)。不同病理的手术时间、术中出血量和并发症发生率比较,差异有统计学意义(P<0.05)。结论腹腔镜经腹腹膜前疝修补术中分离腹膜学习曲线为15例左右,缝合腹膜为20例左右。Objective To investigate the learning curve of different surgical steps of laparoscopic transabdominal preperitoneal prosthesis(TAPP).Methods The clinical data of 92 cases of TAPP operation carried out by the same group of doctors in Wuhu traditional Chinese Medicine hospital was analyzed retrospectively.The operation was divided into two main steps:separating peritoneal stage and suturing peritoneal stage.Recording operation time and completion time of each stage according to operation date.With the help of SPSS software the learning curve was obtained by using moving average method and cumulative-sum method.The surgery was divided into two phase according to the results of study curve,the operation time,the amount of bleeding,postoperative complications and postoperative hospital stay of each phase were compared.Results The time cut of the learning curve of separated peritoneum and patch placement was similar to each other.The learning curve OF sutured peritoneum was different to another two steps.There were no statistical difference in general data,operation time,blood loss,postoperative complications between different phase(P>0.05).The operative time,intraoperative blood loss and complication rate of different pathology was statistically significant(P<0.05).Conclusions During the laparoscopic transabdominal preperitoneal prosthesis,there were 15 cases of learning curve of separating peritoneal stage and 21cases of suturing peritoneal stage.

关 键 词：腹股沟疝 学习曲线 疝修补术 累积和法 

分 类 号：R656.21[医药卫生—外科学]