老年患者3D单孔胸腔镜单向式解剖性右肺上叶切除术的学习曲线

Learning curve of single-direction anatomical right upper lobectomy by 3D uniportal video-assisted thoracoscopy in elderly patients

中文关键词: 老年  肺癌  3D胸腔镜  单孔  单向式  肺叶切除术  学习曲线

英文关键词: elderly  lung cancer  3D video-assisted thoracoscopy  uniportal  single-direction  lobectomy  learning curve

中文摘要:

      目的 探讨老年患者3D单孔胸腔镜单向式解剖性右肺上叶切除术的学习曲线.方法 回顾性分析2021年1月-2022年12月收治的53例非小细胞肺癌老年患者的临床资料,采用CUSUM分析对3D单孔胸腔镜单向式解剖性右肺上叶切除术的学习曲线进行分析.结果 平均手术时间为(155.15±31.13)min(100～230 min);学习曲线的截点值等于23,提示术者至少需经历23例手术才能逐步熟练掌握该术式.将53例患者按照学习曲线的截点值分为A组和B组,A组在手术时间、术中出血量、术后住院时间等明显多于B组,差异均有统计学意义(均P＜0.05).2组在淋巴结清扫数量、术后切口疼痛评分(术后24、48 h)、术后24 h引流量、胸管留置时间、术后并发症等差异均无统计学意义(均P＞0.05).结论 跨越学习曲线达到熟练操作可能约需累积23例手术经验.

英文摘要:

      Objective To explore the learning curve of single-direction anatomical right upper lobectomy by 3D unipor-tal video-assisted thoracoscopy in elderly patients.Methods The clinical data of 53 elderly patients with non-small cell lung cancer admitted from January 2021 to December 2022 were retrospectively analyzed.CUSUM analysis was used to analyze the learning curve of single-direction anatomical right upper lobectomy by 3D uniportal video-assisted thoracoscopy.Results The average operation time was(155.15±31.13)min(100～230 min).The cut-off value of the learning curve was 23,which indicated that the surgeon needed to undergo at least 23 surgeries to gradually master the technique.The 53 patients were divid-ed into group A and group B according to the cut-off value of the learning curve.The group A had significantly longer opera-tion time,greater intraoperative blood loss,and longer postoperative hospital stay than those of the group B,and the differences were statistically significant(all P＜0.05).There were no significant differences between the two groups in the number of lymph nodes dissection,postoperative incision pain score(24 h and 48 h after surgery),drainage volume 24 h after surgery,thoracic tube retention time,and postoperative complications(all P＞0.05).Conclusion It may require accumulating ap-proximately 23 surgical experiences to cross the learning curve to achieve skilled operation.