Kim Song Yi, Hong Sung Gun, Roh Hye Rin, Park Seong Bae, Kim Yang Hee, Chae Gi Bong
Department of Surgery, Kangwon National University School of Medicine, Chuncheon, Korea.
J Korean Soc Coloproctol. 2010 Oct;26(5):324-8. doi: 10.3393/jksc.2010.26.5.324. Epub 2010 Oct 31.
The laparoscopic appendectomy has been a basic part of the principal of a more complex laparoscopic technique for the surgical trainee. As the number of laparoscopic appendectomies performed by surgical trainees has increased, we are trying to check the stability of, which is controversial, and the learning curve associated with a laparoscopic appendectomy.
We studied the demographics, histologic diagnoses, operative time, the number of complicated cases, and hospital duration of one hundred and three patients who underwent an open appendectomy (group A, 53) or a laparoscopic appendectomy (group B, 50) retrospectively through a review of their medical records. The learning curve for the laparoscopic appendectomy was established through the moving average and ANOVA methods.
There were no differences in the operative times (A, 64.15 ± 29.88 minutes; B, 58.2 ± 20.72 minutes; P-value, 0.225) and complications (A, 11%; B, 6%; P-value, 0.34) between group A and group B. Group B was divided into group C who underwent the operation in the early period (before the learning curve) and group D who underwent the operation in the later period (after the learning curve). The average operative time for group C was 66.83 ± 21.55 minutes, but it was 45.25 ± 10.19 minutes for group D (P-value < 0.0001). Although this difference was statistically significant, no significant difference in the complication rate was observed between the two groups.
A laparoscopic appendectomy, compared with an open appendectomy, performed by a surgical trainee is safe. In this study, the learning curve for a laparoscopic appendectomy was thirty cases.
对于外科实习生而言，腹腔镜阑尾切除术一直是更复杂腹腔镜技术原则的基本组成部分。随着外科实习生进行的腹腔镜阑尾切除术数量增加，我们试图检验腹腔镜阑尾切除术存在争议的稳定性以及与之相关的学习曲线。
我们通过回顾103例接受开腹阑尾切除术（A组，53例）或腹腔镜阑尾切除术（B组，50例）患者的病历，对其人口统计学资料、组织学诊断、手术时间、复杂病例数及住院时间进行了回顾性研究。通过移动平均法和方差分析方法确定腹腔镜阑尾切除术的学习曲线。
A组和B组在手术时间（A组，64.15±29.88分钟；B组，58.2±20.72分钟；P值，0.225）和并发症发生率（A组，11%；B组，6%；P值，0.34）方面无差异。B组分为早期（学习曲线之前）接受手术的C组和后期（学习曲线之后）接受手术的D组。C组的平均手术时间为66.83±21.55分钟，而D组为45.
