单向式全胸腔镜肺癌切除术的学习曲线分析

被引：15

作者：

蒲强

刘伦旭

车国卫

王允

寇瑛琍

刘成武

马林

梅建东

朱云柯

机构：

[1] 四川大学华西医院胸外科

来源：

中华外科杂志 | 2010年 / 15期

关键词：

胸腔镜检查; 肺肿瘤; 肺切除术;

D O I：

暂无

中图分类号：

R734.2 [肺肿瘤];

学科分类号：

摘要：

目的分析单向式全胸腔镜肺癌切除术的学习曲线。方法前瞻性收集2006年5月至2009年4月由两名医师完成的125例全胸腔镜肺癌切除术的临床资料。将手术病例按主刀医师分为A(n=24)、B(n=101)两组,并将B组按时间顺序根据患者例数分为B1(n=25)、B2(n=25)、B3(n=25)、B4(n=26)组。A组手术医师开展胸腔镜手术2年,B组手术医师开展胸腔镜手术5年。比较各组的手术时间、术中失血量、清扫淋巴结数目、中转开胸率、术后并发症发生率。结果与B组比较,A组手术时间较长[(237±85)min比(187±43)min,P=0.013],而术中失血量、清扫淋巴结数目、中转开胸率、术后并发症发生率两组间差异无统计学意义(P<0.05)。A组与B1组比较也有相同结果。B组中从B1组到B4组手术时间逐渐缩短、术中失血量逐渐减少,但差异无统计学意义(P<0.05)。而B组中前50例(B1+B2)与后51例(B3+B4)比较术中失血量减少[(122±141)ml比(87±81),P=0.009]。结论在开展完全胸腔镜肺癌切除的早期阶段,手术时间会较长,这在腔镜手术经历较短的医生更明显,但并发症发生率无显著增加。完成50例全胸腔镜肺癌切除手术可作为评价熟练掌握该手术的指标。

引用

页码：1161 / 1165

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