单一术者机器人辅助单孔腹腔镜前列腺癌根治术学习曲线分析  

Analysis of single port robot-assisted laparoscopic prostatectomy curve of one single surgeon

作　　者：魏勇 沈露明 朱辰[2] 成向明 魏云飞[2] 袁琳[2] 苏健[2] 朱清毅 Wei Yong;Shen Luming;Zhu Chen;Cheng Xiangming;Wei Yunfei;Yuan Lin;Su Jian;Zhu Qingyi(Department of Urology,the Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,China;Department of Urology,the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京医科大学第二附属医院泌尿外科,210011 [2]南京中医药大学附属医院泌尿外科,210029

出　　处：《中华腔镜泌尿外科杂志（电子版）》2023年第1期30-35,共6页Chinese Journal of Endourology(Electronic Edition)

基　　金：江苏省卫生健康委员会科研项目(ZD2021028)。

摘　　要：目的评估单一术者在不同时间段开展的机器人辅助单孔腹腔镜前列腺癌根治术(sp-RALP)之手术效果,探讨该手术方式的学习曲线。方法回顾性分析南京中医药大学附属医院2020年1月至2020年12月由同一手术医师连续完成的100例sp-RALP的临床资料。按时间顺序将患者分为5组(A组即第一阶段组为第1~20例,B组即第二阶段组为第21~40例,C组即第三阶段组为第41~60例,D组即第四阶段组为第61~80例,E组即第五阶段组为第81~100例),比较5组间的手术时间、术中出血、引流管留置时间、术后住院天数等方面的差异。结果随术者经验例数的累积,手术时间、术中出血量均呈下降趋势,A、B两组与C、D、E三组间分别对比差异均有统计学意义(P均<0.05),A组与B组间对比仅手术时间的差异存在统计学意义(P<0.05),C、D、E三组间两两对比差异均无统计学意义(P均>0.05);而引流管留置时间、术后住院天数各组间研究的差异均无统计学意义(P均>0.05)。结论机器人辅助单孔腹腔镜前列腺癌根治术(sp-RALP)学习曲线相对陡峭,大约在40例手术经验积累之后基本掌握该技术,手术时间明显缩短,出血量明显减少。Objective To evaluate the effect of single port robot-assisted laparoscopic prostatectomy(sp-RALP)performed by a single surgeon in different time periods,and explore the learning curve of the surgical method.Method A retrospective analysis of the clinical data of 100 prostate cancer patients received sp-RALP by the same surgeon in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2020 to December 2020 was conducted.Patients were divided into 5 groups in chronological order:group A(group in stage 1)included cases 1-20,group B(group in stage 2)included cases 21-40,group C(group in stage 3)included cases 41-60,group D(group in stage 4)included cases 61-80 and group E(group in stage 5)included cases 81-100.The operation time,intraoperative bleeding,indwelling time of drainage tube,and postoperative hospital stay among the 5 groups were compared.Results With increasing experiences,the operation time and intraoperative blood loss showed a downward trend.The differences among group A and groups C,D,and E were statistically significant and the differences among group B and groups C,D,and E were also statistically significant(P<0.05).groups A and B only exhibited a statistically significant difference in operation time(P<0.05),whereas,there was no statistically significant difference between the pairwise comparisons of groups C,D,and E(P>0.05).There were also no statistically significant differences in the drainage tube indwelling time and postoperative hospital stay among these groups(P>0.05).Conclusions The sp-RALP learning curve is relatively steep,and the technique is basically grasped after about 40 cases of surgical experience accumulation.The operation time is significantly shortened,and the amount of bleeding is significantly reduced.

关 键 词：机器人 前列腺癌 单孔腹腔镜 学习曲线 

分 类 号：R699.5[医药卫生—泌尿科学]