老年患者3D单孔胸腔镜单向式解剖性右肺上叶切除术的学习曲线
Learning curve of single-direction anatomical right upper lobectomy by 3D uniportal video-assisted thoracoscopy in elderly patients
茅怡铭 1陆文强 1戴春雷2
作者信息
- 1. 上海交通大学医学院苏州九龙医院胸外二科,江苏苏州 215028
- 2. 南京医科大学附属苏州医院胸外科,江苏苏州 215000
- 折叠
摘要
目的 探讨老年患者3D单孔胸腔镜单向式解剖性右肺上叶切除术的学习曲线.方法 回顾性分析2021年1月-2022年12月收治的53例非小细胞肺癌老年患者的临床资料,采用CUSUM分析对3D单孔胸腔镜单向式解剖性右肺上叶切除术的学习曲线进行分析.结果 平均手术时间为(155.15±31.13)min(100～230 min);学习曲线的截点值等于23,提示术者至少需经历23例手术才能逐步熟练掌握该术式.将53例患者按照学习曲线的截点值分为A组和B组,A组在手术时间、术中出血量、术后住院时间等明显多于B组,差异均有统计学意义(均P＜0.05).2组在淋巴结清扫数量、术后切口疼痛评分(术后24、48 h)、术后24 h引流量、胸管留置时间、术后并发症等差异均无统计学意义(均P＞0.05).结论 跨越学习曲线达到熟练操作可能约需累积23例手术经验.
Abstract
Objective To explore the learning curve of single-direction anatomical right upper lobectomy by 3D unipor-tal video-assisted thoracoscopy in elderly patients.Methods The clinical data of 53 elderly patients with non-small cell lung cancer admitted from January 2021 to December 2022 were retrospectively analyzed.CUSUM analysis was used to analyze the learning curve of single-direction anatomical right upper lobectomy by 3D uniportal video-assisted thoracoscopy.Results The average operation time was(155.15±31.13)min(100～230 min).The cut-off value of the learning curve was 23,which indicated that the surgeon needed to undergo at least 23 surgeries to gradually master the technique.The 53 patients were divid-ed into group A and group B according to the cut-off value of the learning curve.The group A had significantly longer opera-tion time,greater intraoperative blood loss,and longer postoperative hospital stay than those of the group B,and the differences were statistically significant(all P＜0.05).There were no significant differences between the two groups in the number of lymph nodes dissection,postoperative incision pain score(24 h and 48 h after surgery),drainage volume 24 h after surgery,thoracic tube retention time,and postoperative complications(all P＞0.05).Conclusion It may require accumulating ap-proximately 23 surgical experiences to cross the learning curve to achieve skilled operation.
关键词
老年/肺癌/3D胸腔镜/单孔/单向式/肺叶切除术/学习曲线Key words
elderly/lung cancer/3D video-assisted thoracoscopy/uniportal/single-direction/lobectomy/learning curve引用本文复制引用
基金项目
2022年苏州市医学创新应用研究(SKY2022094)
2023年苏州市医学创新应用研究(SKY2023203)
出版年
2024
国家科技期刊平台
NSTL
万方数据