摘要
目的:探讨机器人根治性远端胃与全胃切除术的学习曲线。方法:回顾分析2020年8月至2022年8月47例机器人根治性远端胃切除术与32例机器人根治性全胃切除术的临床资料,年龄、BMI、出血量、手术时间、术后住院时间、淋巴结清扫数量等计量资料采用独立样本t检验;术后并发症发生率、性别等计数资料采用χ^(2)检验,按照手术时间顺序收集并分析病例资料,每种手术以手术时间为参数进行累积与分析并构建学习曲线,找出曲线转折点。结果:机器人根治性远端胃与全胃切除术的学习曲线分别在28例、16例出现转折点。机器人根治性远端胃切除术学习曲线转折点的前后两组在性别、年龄、BMI、出血量、手术时间、清扫淋巴结数量方面差异均无统计学意义(P>0.05),但转折点前后两组术后住院时间、术后并发症发生率差异有统计学意义(P<0.001,P=0.027)。机器人根治性全胃切除术学习曲线转折点前后两组患者的年龄、BMI、出血量、清扫淋巴结数量、手术时间、并发症发生率差异均无统计学意义(P>0.05),性别差异有统计学意义(P=0.033)。结论:跨越机器人根治性远端胃切除术与全胃切除术的学习曲线所需的病例数分别为28例与16例。
Objective:To explore the learning curves of robotic distal gastrectomy and robotic total gastrectomy for gastric cancer.Methods:A retrospective analysis was made on the clinical data of 47 cases of robotic distal gastrectomy and 32 cases of robotic total gastrectomy from Aug.2020 to Aug.2022.Data of cases,including age,BMI,bleeding volume,operation time,postoperative hospital stay and the number of lymph nodes dissection were compared by independent t-test.The chi-square test was used to compare the incidence of postoperative complications and gender ratio.The case data were collected and analyzed in the order of operation time.The learning curves of 2 operation types were evaluated using the cumulative sum analysis and turning points were confirmed.Results:The turning point of the learning curve about robotic distal gastrectomy and total gastrectomy was 28 cases and 16 cases.There were no significant differences in gender ratio,age,BMI,bleeding volume,operation time and the number of lymph nodes dissected between before and after turning point of robotic distal gastrectomy(P>0.05).There were significant differences in mean postoperative hospital stay and incidence of postoperative complications before and after turning point of robotic distal gastrectomy(P<0.001,P=0.027).There were no significant differences in age,BMI,bleeding volume,number of lymph nodes dissected,operation time and incidence of postoperative complications between the two groups before and after turning point of robotic total gastrectomy(P>0.05).There were significant differences in the gender ratio of robotic total gastrectomy(P=0.033).Conclusions:The number of cases required to cross the learning curves of robotic distal gastrectomy and total gastrectomy is 28 and 16,respectively.
作者
王天启
何亮
李梦
张世伟
王权
WANG Tian-qi;HE Liang;LI Meng(Department of Gastrocolorectal Surgery,the First Hospital of Jilin University,Changchun 130021,China)
出处
《腹腔镜外科杂志》
2023年第1期17-21,共5页
Journal of Laparoscopic Surgery
基金
北京市希思科临床肿瘤学研究基金(Y-MSDPO2021-0281)
2021年度白求恩医学工程与仪器中心项目(BQEGCZX2021010)。
关键词
胃肿瘤
胃癌根治术
机器人手术
学习曲线
Stomach neoplasms
Radical gastrectomy of gastric cancer
Robotic surgical procedures
Learning curve
