Chen Gang, Liu Zheng, Han Peng, Li Jing-Wen, Cui Bin-Bin
Department of Colorectal Surgery, The Affiliated Tumor Hospital of Harbin Medical University, Harbin, China.
J Laparoendosc Adv Surg Tech A. 2013 Jan;23(1):17-21. doi: 10.1089/lap.2011.0540.
The purpose of this study was to evaluate the learning curve of the laparoscopic approach for colorectal cancer and generate a focused training program for more junior surgeons.
This study analyzed data from 100 consecutive laparoscopic surgeries for colorectal cancer between January 2009 and July 2010. The learning curve was compared between the first 50 surgeries (study group 1) and the subsequent 50 surgeries (study group 2).
Age, gender, mean body mass index, history of abdominal surgery, and tumor stage were not significantly different between the two study groups. Operative time decreased with increasing experience and reached a plateau after 23 patients. The operative time in study group 2 tended to be shorter than in study group 1 (P=.06). Other parameters including blood loss, average number of retrieved lymph nodes, conversion rate, and intraoperative complication rates were not different between the two study groups.
More junior surgeons can be safely trained if they are exposed to a focused training program. Supervision by an experienced surgeon and considerable experiences in open colorectal surgery are assets for an accelerated learning curve.
本研究的目的是评估腹腔镜结直肠癌手术的学习曲线，并为低年资外科医生制定一个有针对性的培训方案。
本研究分析了2009年1月至2010年7月间连续进行的100例腹腔镜结直肠癌手术的数据。比较了前50例手术（研究组1）和后50例手术（研究组2）的学习曲线。
两个研究组在年龄、性别、平均体重指数、腹部手术史和肿瘤分期方面无显著差异。手术时间随着经验的增加而减少，在23例患者后达到平台期。研究组2的手术时间倾向于比研究组1短（P = 0.06）。两个研究组在其他参数方面，包括失血量、平均切除淋巴结数、中转率和术中并发症发生率，均无差异。
如果低年资外科医生接受有针对性的培训方案，他们可以得到安全的培训。由经验丰富的外科医生进行监督以及在开放结直肠癌手术方面有丰富经验，有助于加速学习曲线。
