[1]曲戈 张恒 钱如林**.支气管优先处理法单操作孔胸腔镜右肺上叶癌根治术的学习曲线[J].中国微创外科杂志,2023,01(11):835-838.
　Qu Ge,Zhang Heng,Qian Rulin..The Learning Curve of Single Utility Port Video Assisted Thoracoscopic Surgery for Right Upper Lobe Lung Cancer Using a Bronchusfirst Method[J].Chinese Journal of Minimally Invasive Surgery,2023,01(11):835-838.
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支气管优先处理法单操作孔胸腔镜右肺上叶癌根治术的学习曲线()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年11期
页码:
835-838
栏目:
临床研究
出版日期:
2023-11-25

文章信息/Info

Title:
The Learning Curve of Single Utility Port Video Assisted Thoracoscopic Surgery for Right Upper Lobe Lung Cancer Using a Bronchusfirst Method
作者:
曲戈 张恒 钱如林**
(河南省胸科医院郑州大学附属胸科医院胸外科，郑州450000)
Author(s):
Qu Ge;  Zhang Heng;  Qian Rulin.
Department of Thoracic Surgery, Henan Provincial Chest Hospital, Chest Hospital of Zhengzhou University, Zhengzhou 450000, China
关键词:
支气管优先处理法; 单操作孔胸腔镜手术; 右肺上叶癌; 学习曲线; 累积和法
Keywords:
Bronchusfirst method; Single utility port VATS; Right upper lobe lung cancer; Learning curve; Cumulative sum
文献标志码:
A
摘要:
目的探讨具备单向式单操作孔胸腔镜肺癌根治术经验的治疗组开展支气管优先处理法单操作孔胸腔镜右肺上叶癌根治术的学习曲线特征。方法回顾性分析该手术团队2018年4月~2020年12月连续完成支气管优先处理法单操作孔胸腔镜右肺上叶癌根治术98例资料，使用累积和法(cumulative sum，CUSUM)分析学习曲线，并对学习曲线不同阶段围手术期指标进行比较。结果该学习曲线最佳拟合方程为：y=1.512+1.760x-1.775×10-2x2-1.222× 10-5x3，拟合优度R2=0.976。根据该方程，连续实施48例本术式后可进入熟练阶段(第49~98例)，之前为学习阶段(第1~48例)。熟练阶段淋巴结清扫个数多于学习阶段(P<0.05)，而手术时间、术中出血量、切割缝合器钉匣数均少于学习阶段(P<0.05)，2个阶段清扫淋巴结组数、中转开胸率、术后住院时间、术后并发症率差异均无显著性(P>0.05)。结论在具备单向式单操作孔胸腔镜肺癌根治术经验的治疗组，经过48例手术后可熟练掌握支气管优先处理法单操作孔胸腔镜右肺上叶癌根治术。
Abstract:
ObjectiveTo investigate the learning curve of bronchusfirst method for single utility port video assisted thoracoscopic surgery (VATS) of right upper lobectomy performed by a surgical team with former singledirection single utility port VATS lobectomy experience.MethodsA retrospective study was conducted on clinical data of 98 consecutive patients who underwent VATS of right upper lobectomy (bronchusfirst method) by the surgical team for nonsmall cell lung cancer (NSCLC) from April 2018 to December 2020. The learning curve was studied by cumulative sum (CUSUM) analysis. Perioperative data were compared between different stages of the learning curve.ResultsThe learning curve was best modeled as an equation: y=1.512+1.760x-1.775×10-2x2-1.222×10-5x3, with a goodtofit test R2=0.976. According to the equation, after 48 consecutive cases of this procedure, surgeon could enter the mastery stage (Case 49-Case 98), and the previous stage was the learning stage (Case 1-Case 48). More lymph node were harvested in the mastery stage than in the learning stage (P<0.05), and the operation time, blood loss, and the nomber of endoscopic stapler in the mastery stage were fewer (P<0.05). No significance was found in lymph node stations, thoracotomy conversion, postoperative hospital stay, and postoperative complications between the two stages (P>0.05).ConclusionIn a surgical team with former singledirection single utility port VATS lobectomy experience, after 48 procedures, a surgeon can master bronchusfirst method for single utility port VATS of right upper lobectomy.

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备注/Memo

备注/Memo:
基金项目：河南省医学科技攻关计划联合共建项目(2018020545)**通讯作者，Email：gianrulin0371@163.com
更新日期/Last Update: 2024-02-06