北京大学学报（医学版）2012，Vol.44Issue(4)：558-562,5.DOI:10.3969/j.issn.1671-167X.2012.04.015
腹腔镜膀胱全切手术:单中心60例学习曲线结果分析
Laparoscopic radical cystectomy: analysis of a single-surgeon learning curve of 60 cases
郑卫 1周利群 1吴鑫 1张雷 1宋刚 1张争 1龚侃 1宋毅 1李学松 1何志嵩1
作者信息
- 1. 北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京100034
- 折叠
摘要
Abstract
Objective: To evaluate the changes in perioperative outcomes that might refect progress along the learning curving by a single-surgeon' s experience in our institution with laparoscopic radical cystectomy ( LRC). Methods: This report was conducted between May 2004 and January 2012 in 60 patients (9 women and 51 men) who underwent LRC for bladder cancer. The mean patient age was (60.8 ±11.4) years, and mean BMI was (23.9 ±2.7) kg/m2. We divided the patients into 3 groups ( group A, group B, and group C; each group had twenty patients) by the time, and compared the operative time, intraoperative blood loss, hospital stay among the three groups. Results: The mean intraope-rative blood loss was (799. 2 ±717. 8) mL, the mean operative time was (420. 2 ± 119. 8) minutes, and the mean hospital stay was (15. 7 ±11.0) d; There was no statistically significant difference in age, American Society of Ansthesiologists (ASA) scores and BMI among the three groups (P＞0.05). Their operative time was (497.5 ±131.2) , (413.6 ±75.6) and (349.4 ±100.2) minutes, respectively, for each group, P ＜0.001. The intraoperative blood loss was ( 1 080.0 ± 1 028. 8 ) , ( 862. 5 ± 510.6) and (455.5 ±262.3) mL, for each group, P =0.018. The hospital stay was (20. 8 ± 13. 5) , ( 16. 4 ± 10.6) and (9. 8 ±4.4) d, for each group, P =0.005. However, there was no statistically significant difference in postoperative complications among the three groups. Conclusion: Our experience of LRC appears to be favorable with reduction in blood loss, operative time and hospital stay with increasing experience. The curving shows a significant decline at 2 different breakpoints; after the first 20 cases, and after 40 cases.关键词
膀胱肿瘤/膀胱切除术/学习曲线/膀胱镜检查Key words
Bladder cancer/ Cystectomy/ Learning curving/ Laparoscopy分类
医药卫生引用本文复制引用
郑卫,周利群,吴鑫,张雷,宋刚,张争,龚侃,宋毅,李学松,何志嵩..腹腔镜膀胱全切手术:单中心60例学习曲线结果分析[J].北京大学学报（医学版）,2012,44(4):558-562,5.
