결장직장 질환에서 수부보조 복강경 수술과 고식적 복강경 수술의 습득곡선 비교

• 영문명: Learning Curve for Laparoscopic Colorectal Surgery: Hand Assisted Laparoscopic Surgery (HALS) versus Conventional Laparoscopic Surgery (CLS)
• 발행기관: 개인저작물
• 저자명: 윤해란(Hae Ram Yun) 이원석(Won Suk Lee) 윤성현(Seong Hyeon Yun) 이우용(Woo Yong Lee) 전호경(Ho-Kyung Chun)
• 간행물 정보: 『개인저작물 - 의학』대한대장항문학회지 제23권 3호, 161~166쪽, 전체 6쪽
• 주제분류: 의약학 > 개인저작물
• 파일형태: PDF
• 발행일자: 2007.01.01

영문 초록

Purpose: Laparoscopic colorectal surgery is technically demanding and needs a longer learning curve than open surgery. HALS (hand-assisted laparoscopic surgery) is a useful alternative to conventional laparoscopic surgery (CLS) because of its palpability and hand dissection. We compared the learning curves between HALS and CLS for colorectal surgery. Methods: A prospective study without randomization was conducted with the participation of two colorectal surgeons who had not experienced a laparoscopic colorectal operation. The collected data included operative features, oncologic outcomes, and early clinical outcomes. Fifty patients were enrolled in each group, the HALS group and the CLS group. Results: None of the operations converted to open surgery. The operative time was significantly shorter in the HALS group than in the CLS group (149.6±34.6 minutes versus 179.1±36.5 minutes, P<0.001). On a subgroup analysis of the operative time in the anterior resection, the operative time was consistent after the operation in HALS group. However, in CLS group, there was a continuous fluctuation of the operative time until 25 cases. In regard to the oncologic outcome, the numbers of total harvested lymph nodes and the proximal and the distal margins in the anterior resection showed no statistical differences (P=0.400, P=0.908, and P=0.073, respectively). The early clinical results were similar in both groups. Conclusions: In the learning curve study, the HALS group had a shorter operative time and reached a learning curve plateau earlier than the CLS group. Other parameters, such as the oncologic results and the early postoperative clinical outcomes, showed no differences between the two groups. J Korean Soc Coloproctol 2007;23:161-166

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키워드

Learning curve Hand-assisted laparoscopic surgery (HALS) Conventional laparoscopic surgery (CLS) 습득 곡선 수부 보조 복강경 수술 고식적 복강경수술