Learning curve in laparoscopic left lateral hepatic sectionectomy
10.3760/cma.j.cn113884-20220807-00323
- VernacularTitle:腹腔镜肝左外叶切除术的学习曲线
- Author:
Sijia BAI
1
;
Ting BI
;
Fengyang CHEN
;
Chunhui WANG
;
Lei HAN
;
Yufu TANG
;
Jianqiao YE
;
Shaojie JIANG
;
Wenping ZHOU
;
Xiaodong FENG
;
Wei ZHANG
Author Information
1. 北部战区总医院肝胆外科，沈阳 110016
- Keywords:
Laparoscopy;
Left lateral segment liver resection;
Cumulative summation test;
Learning curve
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(3):170-175
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the learning curve in laparoscopic left lateral hepatic sectionectomy.Methods:The clinical data of 62 consecutive patients who underwent left lateral hepatic sectionectomy by a single operator from February 2015 to May 2022 in General Hospital of Northern Theater Command were retrospectively analyzed. There were 22 males and 40 females, with mean ±s.d. of (50.7±11.7) years. The learning curve was depicted and evaluated by using the cumulative summation test. The general information, operation and postoperative indicators of the growth level group and the master level group were compared.Results:The average operation time of the 62 consecutive subjects was (172.9±70.1) minutes. Intraoperative blood loss was 100 (50, 200) ml. Two patients were converted to open hepatectomy. Clavien-Dindo grade I postoperative complications occurred in 20 patients (32.3%), with grade Ⅱ in 1 patient (1.6%) and grade Ⅲb in another patient (1.6%). The learning curve reached its highest point on the 20th patient by using the cumulative summation test. The study subjects were then assigned into the growth level group (patient 1-20) and the master level group (patient 21-62). The master level group had a significantly wider spread of patient age [(52.9±11.0) years vs (46.1±11.9) years], decreased operation time [(146.8±55.6) min vs (227.9±66.7) min], shortened drainage tube removal time [4(3, 5) d vs 6(4, 7) d] and decreased postoperative hospital stay [5(5, 7) d vs 6.5(4, 9) d] (all P<0.05) when compared with the growth level group. Conclusion:Left lateral hepatic sectionectomy was safe and feasible, and a single operator went through a learning curve of 20 patients before he/she could master the operation more proficiently.
