Kim YongHun, Lee WooSurng
Department of Surgery, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, 82, Gugwon-daero, Chungju-si, Chungbuk Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, 82, Gugwon-daero, Chungju-si, Chungbuk Republic of Korea.
World J Emerg Surg. 2016 Aug 5;11:39. doi: 10.1186/s13017-016-0096-z. eCollection 2016.
Single-port laparoscopic appendectomy (SPLA) has the advantage of minimizing abdominal incision scars with patient satisfaction. However, it has the following disadvantages: it provides a narrower surgical field than conventional laparoscopic appendectomy, which requires a considerably longer operative time to achieve surgical skills. This study was conducted to evaluate the learning curve for SPLA.
This study included a total of 120 patients with acute abdomen who visited our emergency department and were diagnosed with acute appendicitis between March 2013 and February 2015. They underwent SPLA by a single surgeon. Patients were divided into 4 groups of 30 patients each according to operation dates. Operative time, time to resume oral intake, length of hospital stay, and postoperative complications were analyzed.
The mean operative time was 59.9 ± 19.9 min. It was shortened after completion of 30 operations and remained unchanged until it was further shortened after completion of 90 operations. There was no significant difference in time to resumption of oral intake or length of hospital stay between the 4 groups. Postoperative complications occurred in 18 patients, but the frequency of the complications was not significantly different between the 4 groups.
The results of this study suggest that surgeons can achieve surgical skills for SPLA after completion of 30 operations and more experienced surgical skills by SPLA successfully after completion of 90 operations.
单孔腹腔镜阑尾切除术（SPLA）具有将腹部切口疤痕最小化且患者满意度高的优点。然而，它存在以下缺点：与传统腹腔镜阑尾切除术相比，其手术视野更窄，这需要相当长的手术时间来掌握手术技巧。本研究旨在评估SPLA的学习曲线。
本研究共纳入2013年3月至2015年2月期间因急腹症就诊于我院急诊科且被诊断为急性阑尾炎的120例患者。他们均由同一外科医生实施SPLA。根据手术日期将患者分为4组，每组30例。分析手术时间、恢复经口进食时间、住院时间及术后并发症。
平均手术时间为59.9±19.9分钟。在完成30例手术后手术时间缩短，在完成90例手术前保持不变，之后进一步缩短。4组患者恢复经口进食时间或住院时间无显著差异。18例患者发生术后并发症，但4组并发症发生率无显著差异。
本研究结果表明，外科医生在完成30例手术后可掌握SPLA的手术技巧，在完成90例手术后可成功获得更熟练的SPLA手术技巧。
