Department of Obstetrics & Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
J Minim Invasive Gynecol. 2012 May-Jun;19(3):344-9. doi: 10.1016/j.jmig.2012.01.003. Epub 2012 Feb 8.
To compare learning curves for laparoendoscopic single-site surgery (LESS) for ovarian tumors according to the type of procedure (oophorectomy vs cystectomy).
A prospective cohort study. (Canadian Task Force Classification II-2).
University hospital.
One hundred fifteen patients who planned to undergo LESS for ovarian tumors by a surgeon between May 2008 and August 2010.
LESS.
The learning curve was assessed through the graph between the operative time and sequence of cases. Proficiency, defined as the point at which the slope of the learning curve became less steep, and surgical outcome were compared between the two surgery groups. LESS was successfully completed in 103 of 115 patients (94.8%). Learning curve for oophorectomies (n = 59) showed a continued slow slope with no apparent proficiency, suggesting oophorectomies did not pose an initial technical challenge. However, proficiency in cystectomies (n = 56) was evident at the thirty-third case. Furthermore, the oophorectomy group had a shorter operative time and less need for additional ports than the cystectomy group (69.4 minutes vs 100.1 minutes; 5.1% vs 14.3%).
Oophorectomy rather than cystectomy is recommended as the initial procedure to start with LESS for ovarian tumors.
比较经脐单孔腹腔镜手术（LESS）治疗卵巢肿瘤的学习曲线，根据手术类型（卵巢切除术与囊肿切除术）进行比较。
前瞻性队列研究。（加拿大工作队分类 II-2）。
大学医院。
2008 年 5 月至 2010 年 8 月间，由一名外科医生计划行 LESS 治疗卵巢肿瘤的 115 名患者。
LESS。
通过手术时间与病例序列之间的图形来评估学习曲线。熟练程度定义为学习曲线斜率变得较不陡峭的点，并比较两组手术的手术结果。115 例患者中有 103 例（94.8%）成功完成 LESS。卵巢切除术（n = 59）的学习曲线显示持续缓慢的斜率，没有明显的熟练程度，表明卵巢切除术一开始并不具有技术挑战性。然而，囊肿切除术（n = 56）的熟练程度在第 33 例时就很明显。此外，卵巢切除术组的手术时间比囊肿切除术组短，需要额外的端口也更少（69.4 分钟比 100.1 分钟；5.1%比 14.3%）。
与囊肿切除术相比，卵巢切除术更适合作为 LESS 治疗卵巢肿瘤的初始手术。
