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机器人远端胃癌根治术的学习曲线
引用本文:刘东宁,何鹏辉,熊强强,唐城,江群广,李太原. 机器人远端胃癌根治术的学习曲线[J]. 中华腔镜外科杂志(电子版), 2016, 9(6): 335-338. DOI: 10.3877/cma.j.issn.1674-6899.2016.06.005
作者姓名:刘东宁  何鹏辉  熊强强  唐城  江群广  李太原
作者单位:1. 330006 南昌大学第一附属医院普外科
基金项目:国家青年科学基金(81402401); 江西省自然科学基金(20142BAB215042)
摘    要:
目的探讨机器人远端胃癌根治术的学习曲线。 方法回顾分析南昌大学第一附属医院普外科同一组团队2015年2月至5月完成的30例机器人远端胃癌根治手术患者的临床资料。按患者进行手术的时间先后分为A、B、C组,每组10例 ,比较3组的机器人安装时间,以及反映术中情况和术后恢复情况的数项指标。 结果3组患者的年龄、性别、术前体质量指数、既往腹部手术史及术前分期、手术方式比较,差异均无统计学意义(P> 0.05);与A组相比,B、C组的机器人安装时间短[A、B、C组分别为(28.5 ± 6.3)min、(15.1 ± 4.5) min、(14.7 ± 2.9) min, P<0.05],手术时间短[A、B、C组分别为(272.3 ± 46.1) min、(206.4 ± 38.3) min、(202.5 ± 40.3) min,P<0.05],术中出血量少[A、B、C组分别为(131.3 ± 10.1) ml、(61.4 ± 16.3) ml、(59.8 ± 17.9) ml,P< 0.05],淋巴结清扫数量多[A、B、C组分别为(18.4 ± 4.1) 枚、(25.7 ± 4.6) 枚、(26.3 ± 4.8) 枚,P<0.05]。B、C组比较,均差异无统计学意义 (P>0.05) 。3组的肛门排气时间、术后住院时间及并发症发生率比较,差异无统计学意义(P>0.05) 。A组的10例手术在2个月内完成,平均每个月5台手术;B组和C组的手术均在1个月内完成 ,平均每个月10台手术。 结论有丰富腹腔镜远端胃癌手术经验的外科医师行机器人远端胃癌根治术的学习曲线约为10例 ,手术频度为平均每个月5例。

关 键 词:机器人手术系统  胃癌  学习曲线  
收稿时间:2016-11-27

Learning curve of robot-assisted radical distal gastrectomy for gastric cancer
Dongning Liu,Penghui He,Qiangqiang Xiong,Cheng Tang,Qunguang Jiang,Taiyuan Li. Learning curve of robot-assisted radical distal gastrectomy for gastric cancer[J]. Chinese Journal of Laparoscopic Surgery ( Electronic Editon), 2016, 9(6): 335-338. DOI: 10.3877/cma.j.issn.1674-6899.2016.06.005
Authors:Dongning Liu  Penghui He  Qiangqiang Xiong  Cheng Tang  Qunguang Jiang  Taiyuan Li
Affiliation:1. Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
Abstract:
ObjectiveTo investigate the learning curve of robot-assisted radical distal gastrectomy for gastric cancer. MethodsIn order to analysis the clinical data of 30 patients undergoing robot-assisted radical distal gastrectomy from Feb. to May 2015 in our department by same group, the patients were divided into three groups, with 10 cases in each one, marked by A, B and C. Several indexes were used to compared the differences among the 3 groups. ResultsThere were no significant differences in age, sex, pre-operative body mass index (BMI), previous history of abdominal operation, pre-operative TNM stages resection types of the stomach among the three groups (P>0.05). The robotic set-up time of group B and group C was shorter than that of group A, [(28.5 ± 6.3)min, (15.1 ± 4.5) min, (14.7 ± 2.9)min for group A, B and C respectively, P<0.05]; The operation time of group B and group C was shorter than that of group A [(272.3 ± 46.1) min, (206.4 ± 38.3) min, (202.5 ± 40.3) min for group A, B and C respectively, P<0.05]; the blood loss of group B and group C was less than that of group A [(131.3 ± 10.1) ml, (61.4 ± 16.3) ml , (59.8 ± 17.9) ml for group A, B and C respectively, P<0.05]; the number of lymph nodes resected in group B and group C was more than that in group A [(18.4 ± 4.1), (25.7 ± 4.6), (26.3 ± 4.8) for group A, B and C respectively, P<0.05]; no significant difference was found between group B and group C (P>0.05) ; no significant difference was found in exhaust time, postoperative hospital stay and complication rates among the three groups (P>0.05 ) .The 10 patients in group A received the operation within a time period of 2 months (5 cases per month), and groups B and C were done in 1 months (10 cases per month). ConclusionsThe surgeons with abundant experiences of laparoscopic distal gastrectomy cancer surgery can learn the surgical skills after performing 10 robot-assisted radical distal gastrectomy for gastric cancer at the months frequency of 5 cases.
Keywords:Robotic surgical system  Gastric Cancer  Learning curve  
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