腹腔镜经腹腹膜前疝修补术的学习曲线  

Learning Curve of Laparoscopic Transabdominal Preperitoneal Hernia Repair

作　　者：沈浩伟 陈剑[1] 吴峰[1] 邢栋[1] 夏长军[1] 安秋冬 SHEN Haowei;CHEN Jian;WU Feng;XING Dong;XIA Changjun;AN Qiudong(General Surgery Department,the First Affiliated Hospital of Henan University of CM,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院普外科,河南郑州450000

出　　处：《河南医学研究》2022年第2期222-224,共3页Henan Medical Research

基　　金：河南省中医药科学研究专项课题(2019ZY2002)。

摘　　要：目的探讨腹腔镜经腹腹膜前疝修补术(TAPP)的学习曲线。方法回顾性分析河南中医药大学第一附属医院2016年1月至2020年8月收治的66例腹股沟疝患者的临床资料,患者均由同一手术组医生采用腹腔镜TAPP术进行治疗。统计患者的一般临床资料和手术相关资料,采用移动平均线法将66例患者按照手术先后顺序分为A~F共6组,每组11例,分析该手术组医生的学习曲线。结果A组手术操作时间长于B、C、D、E、F组(P<0.001),B组手术操作时间长于C、D、E、F组(P<0.05),C、D、E、F组手术操作时间差异无统计学意义(P>0.05)。各组术中出血量和术后住院时间相比,差异无统计学意义(P>0.05)。结论对于有腹腔镜操作经验的医生,大约30例腹腔镜TAPP术后技术熟练度趋于稳定。选择非复杂疝患者及规范手术操作,可避免技术开展早期术中出血量增加及术后住院时间延长。Objective To explore the learning curve of laparoscopic transabdominal preperitoneal hernia repair(TAPP).Methods The clinical data of 66 patients with inguinal hernia admitted to the First Affiliated Hospital of Henan University of CM from January 2016 to August 2020 were retrospectively analyzed.The patients were all treated by the same surgical team with laparoscopic TAPP.The general clinical data and surgery-related data of the patients were collected.Using the moving average method,66 patients were divided into 6 groups from A to F according to the order of surgery,with 11 cases in each group.The learning curve of the doctors in this surgery group was analyzed.Results The operation time of group A was longer than that of groups B,C,D,E,and F(P<0.001).The operation time of group B was longer than that of groups C,D,E,and F(P<0.05).There was no statistical difference in operation time between groups C,D,E,and F(P>0.05).There was no statistical difference in intraoperative blood loss and postoperative hospital stay among the groups(P>0.05).Conclusion For doctors with experience in laparoscopic operation,the technical proficiency of laparoscopic TAPP will stabilize after about 30 operations.Selecting patients with uncomplicated hernias and standardizing surgical operations could avoid the increase in intraoperative blood loss and the prolonged postoperative hospital stay in the early stage of technical development.

关 键 词：腹股沟疝 腹腔镜 经腹腹膜前疝修补术 学习曲线 

分 类 号：R656[医药卫生—外科学]