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初级外科医师行腹腔镜完全腹膜外疝修补术的初步经验:单中心经验丰富外科医师的比较。

First experience of junior surgeons with laparoscopic totally extraperitoneal herniorrhaphy: Comparison with experienced surgeons in a single institution.

机构信息

Department of Surgery, Dankook University College of Medicine, Chungnam, Republic of Korea.

Department of Surgery, Dankook University College of Medicine, Chungnam, Republic of Korea.

出版信息

Asian J Surg. 2022 Mar;45(3):844-848. doi: 10.1016/j.asjsur.2021.10.018. Epub 2021 Nov 26.

DOI:10.1016/j.asjsur.2021.10.018
PMID:34844831
Abstract

BACKGROUND/OBJECTIVE: Laparoscopic totally extraperitoneal (TEP) herniorrhaphy is among the current leading inguinal hernia repair methods. This study aimed to investigate the safety and feasibility of a junior surgeon's first experience with laparoscopic TEP herniorrhaphy.

METHODS

A retrospective review was performed between January 2017 and December 2019 to analyze the medical records of patients with inguinal hernia who underwent laparoscopic TEP herniorrhaphy. The operative outcomes and complications of patients undergoing surgery by an experienced surgeon (group A, n = 100) were compared with those undergoing surgery by a junior surgeon (group B, n = 100).

RESULTS

The mean operative time for group B was significantly longer than that for group A (52.0 ± 15.1 min vs 60.1 ± 17.4 min; P = 0.03). A statistical difference was also found in the mean postoperative stay (1.1 ± 0.3 d vs 1.4 ± 0.7 d; P = 0.02) between the two groups. There were 2 and 3 cases of recurrence in these two groups respectively (P = 0.72). Considering the operating time as a variable of learning curve, significant stabilization can be achieved after 30 cases (67.3 ± 17.8 min vs 53.1 ± 11.1 min; P = 0.02).

CONCLUSIONS

The surgical outcomes of laparoscopic TEP herniorrhaphy performed by a well-trained junior surgeon were similar to the outcomes of an experience surgeon.

摘要

背景/目的:腹腔镜完全腹膜外(TEP)疝修补术是目前领先的腹股沟疝修补方法之一。本研究旨在探讨初级外科医师首次进行腹腔镜 TEP 疝修补术的安全性和可行性。

方法

回顾性分析 2017 年 1 月至 2019 年 12 月期间接受腹腔镜 TEP 疝修补术的腹股沟疝患者的病历。比较经验丰富的外科医师(A 组,n=100)和初级外科医师(B 组,n=100)手术的手术结果和并发症。

结果

B 组的平均手术时间明显长于 A 组(52.0±15.1min 比 60.1±17.4min;P=0.03)。两组间的平均术后住院时间也存在统计学差异(1.1±0.3d 比 1.4±0.7d;P=0.02)。两组分别有 2 例和 3 例复发(P=0.72)。考虑到手术时间是学习曲线的变量,在完成 30 例手术后可以达到显著稳定(67.3±17.8min 比 53.1±11.1min;P=0.02)。

结论

经过良好培训的初级外科医师进行腹腔镜 TEP 疝修补术的手术结果与经验丰富的外科医师相似。

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