PDF(Pubmed)
Abstract：
BACKGROUND: Due to the large trauma caused by conventional open surgery, minimally invasive esophageal cancer surgery has been gradually carried out, and there is no report on the learning curve for artificial pneumothorax during an endoscopic McKeown-type resection of oesophageal carcinoma.
METHODS: Forty cases of McKeown resection of oesophageal carcinoma with artificial pneumothorax that were completed by the same operator between December 2017 and August 2019 were analysed. The patients were divided into four groups (A, B, C, D) of 10 cases each according to the order of operation. The operation time, intraoperative blood loss, total lymph nodes and left recurrent laryngeal nerve lymph nodes resection, conversion rate, complication rate and hospitalization time were compared between the four groups.
RESULTS: The operation time of the four groups were as follows: A, 243.2±44.1 min; B, 265.0±59.3 min; C, 255.8±41.7 min; D, 201.0±16.2 min, there were significant difference in terms of the operation time between group A, group B, group C and group D (P<0.05). Moreover, groups A and C all differed significantly from group D in the number of dissected left recurrent laryngeal nerve lymph nodes. However, no significant inter-group differences were observed in the number of trans-laparotomy and trans-thoracotomy, number of dissected total lymph nodes, intraoperative blood loss, incidence of postoperative complications and postoperative length of hospital stay (P>0.05).
CONCLUSIONS: Artificial pneumothorax during an endoscopic McKeown-type resection of oesophageal carcinoma required a learning curve of approximately 30 cases.
METHODS: Forty cases of McKeown resection of oesophageal carcinoma with artificial pneumothorax that were completed by the same operator between December 2017 and August 2019 were analysed. The patients were divided into four groups (A, B, C, D) of 10 cases each according to the order of operation. The operation time, intraoperative blood loss, total lymph nodes and left recurrent laryngeal nerve lymph nodes resection, conversion rate, complication rate and hospitalization time were compared between the four groups.
RESULTS: The operation time of the four groups were as follows: A, 243.2±44.1 min; B, 265.0±59.3 min; C, 255.8±41.7 min; D, 201.0±16.2 min, there were significant difference in terms of the operation time between group A, group B, group C and group D (P<0.05). Moreover, groups A and C all differed significantly from group D in the number of dissected left recurrent laryngeal nerve lymph nodes. However, no significant inter-group differences were observed in the number of trans-laparotomy and trans-thoracotomy, number of dissected total lymph nodes, intraoperative blood loss, incidence of postoperative complications and postoperative length of hospital stay (P>0.05).
CONCLUSIONS: Artificial pneumothorax during an endoscopic McKeown-type resection of oesophageal carcinoma required a learning curve of approximately 30 cases.
摘要：
背景：由于常规开放手术造成的巨大创伤，食管癌微创手术已逐步开展,并且没有关于在内镜下McKeown型食管癌切除术中人工气胸的学习曲线的报道。
方法：对2017年12月至2019年8月由同一手术者完成的40例食管癌McKeown切除伴人工气胸患者进行分析。将患者分为四组（A，B,C,D)按操作顺序各10例。操作时间,术中失血,总淋巴结和左喉返神经淋巴结切除术，转化率，比较四组并发症发生率及住院时间。
结果：四组手术时间如下：243.2±44.1min;B,265.0±59.3min;C,255.8±41.7min;D,201.0±16.2分钟，A组手术时间差异有统计学意义,B组,C组和D组(P<0.05)。此外，A组和C组的左喉返神经淋巴结清扫数均与D组有显著差异。然而,经剖腹手术和经胸手术的数量没有观察到显著的组间差异，解剖的总淋巴结数，术中失血,术后并发症发生率及术后住院时间(P>0.05)。
结论：在内镜下McKeown型食管癌切除术中发生人工气胸需要约30例的学习曲线。
方法：对2017年12月至2019年8月由同一手术者完成的40例食管癌McKeown切除伴人工气胸患者进行分析。将患者分为四组（A，B,C,D)按操作顺序各10例。操作时间,术中失血,总淋巴结和左喉返神经淋巴结切除术，转化率，比较四组并发症发生率及住院时间。
结果：四组手术时间如下：243.2±44.1min;B,265.0±59.3min;C,255.8±41.7min;D,201.0±16.2分钟，A组手术时间差异有统计学意义,B组,C组和D组(P<0.05)。此外，A组和C组的左喉返神经淋巴结清扫数均与D组有显著差异。然而,经剖腹手术和经胸手术的数量没有观察到显著的组间差异，解剖的总淋巴结数，术中失血,术后并发症发生率及术后住院时间(P>0.05)。
结论：在内镜下McKeown型食管癌切除术中发生人工气胸需要约30例的学习曲线。
