Tan Kailiang, Wei Liufei, Deng Zengmei, Yao Desheng, Jiang Li
Department of Gynecological Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China.
Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Front Med (Lausanne). 2024 Aug 5;11:1449446. doi: 10.3389/fmed.2024.1449446. eCollection 2024.
To identify the learning curve in ovarian cystectomy by vaginal natural orifice transluminal endoscopic surgery.
Data consist of consecutively ordered patients who underwent ovarian cystectomy via vaginal natural orifice transluminal endoscopic surgery between May 2020 and June 2023. The learning curve of ovarian cystectomy via vaginal natural orifice transluminal endoscopic surgery was measured in terms of the operating time adjusted by multivariate linear regression. A cumulative sum analysis was performed to establish the learning curve. Patients' characteristics and surgical outcomes were compared based on the inflection points of this curve.
The learning curve was divided into two unique phases: phase 1 (1-26 patients), and phase 2 (27-40 patients). The expected operating time in phase 2 was shorter than in phase 1 (86.4 ± 11.2 min vs. 102.0 ± 22.7 min, = 0.021). The time to first postoperative flatus was shorter in phase 2 compared with phase 1 (14.6 ± 6.5 h vs. 20.6 ± 6.3 h, respectively, = 0.008). No significant differences were observed in terms of patient's age, BMI, tumor size, parity, bilateral ovarian tumor, pathological diagnoses, estimated blood loss, postoperative pain score, or perioperative complications between the two phases.
Proficiency in ovarian cystectomy by vaginal natural orifice transluminal endoscopic surgery was achieved after 26 surgeries based on cumulative sum analysis. These findings may provide insight for structured training programs of ovarian cystectomy via vaginal natural orifice transluminal endoscopic surgery.
通过经阴道自然腔道内镜手术确定卵巢囊肿切除术的学习曲线。
数据来自于2020年5月至2023年6月期间连续接受经阴道自然腔道内镜手术的卵巢囊肿切除术患者。通过多变量线性回归调整手术时间来衡量经阴道自然腔道内镜手术卵巢囊肿切除术的学习曲线。进行累积和分析以建立学习曲线。根据该曲线的拐点比较患者特征和手术结果。
学习曲线分为两个独特阶段：阶段1（1 - 26例患者）和阶段2（27 - 40例患者）。阶段2的预期手术时间比阶段1短（86.4 ± 11.2分钟对102.0 ± 22.7分钟，P = 0.021）。阶段2术后首次排气时间比阶段1短（分别为14.6 ± 6.5小时对20.6 ± 6.3小时，P = 0.008）。在患者年龄、体重指数、肿瘤大小、产次、双侧卵巢肿瘤、病理诊断、估计失血量、术后疼痛评分或围手术期并发症方面，两个阶段之间未观察到显著差异。
根据累积和分析，经阴道自然腔道内镜手术进行卵巢囊肿切除术在26例手术后达到熟练水平。这些发现可能为经阴道自然腔道内镜手术卵巢囊肿切除术的结构化培训计划提供见解。
