ABSTRACT
Objective To investigate the learning curve of laparoscopy-assisted anorectoplasty in the treatment of high imperforate anus.Methods Sixty patients with high congenital anal atresia who were treated with laparoscopy-assisted anorectoplasty in the Capital Institute of Pediatrics from December 2008 to October 2015 by one experience surgeon were selected as observation group.Based on the criteria,the patients were divided into 4 groups(15 cases in each group) according to the sequence of the operation and every 15 cases served as a learning phase.The operating time,frequency of operation,complication rate,conversion rate to open surgery,blood loss,the rates of blood transfusion and hospital stay were compared among the 4 phases.Results The mean operation duration was (176.3 ±41.6) min,(128.8 ± 36.1) min,(127.3 ± 35.2) min,(124.0 ± 30.1) min in group A,B,C and D,respectively.The operation duration of 4 groups showed a declining trend.Group A has longer operation time than group B,C and D,the difference were statistically significant (P < 0.05).In detail,the comparison of operation time between group A and group B was statistically significant (P < 0.05).Furthermore,group A had significantly more median blood loss than group B,C and D,the differences were statistically significant [the 4 groups of data,respectively,group A:(17.5 ±6.5) mL,group B:(15.0±5.0) mL,group C:(14.5 ±5.5) mL,group D:(8.5 ±6.5) mL,P<0.05].The mean capacity of blood loss was 12.7 mL.No significant difference was found in surgical complications,the rates of blood transfusion,total hospital stay,and postoperative hospital stay among the 4 groups(P > 0.05).But the postoperative hospital stay decreased from 9.8 d (group A) to 7.4 d (group D).Conclusions For a well-trained surgeon in imperforate anus surgery.The learning curve of laparoscopy-assisted anorectoplasty in the treatment of high imperforate anus on about 15 cases helps to make a skillful surgeon.
ABSTRACT
Objective Using the scientific thinking mode,applied the standardized training in zero-based assistant of laparoscopic gastrointestinal surgery,observe and explore the effect of shorten learning curve.Methods Took 40 students studied in our hospital from February 2013 to December 2014 as object of our study,who were randomly divided into Group Ⅰ and Group Ⅱ.Group Ⅰ was given standardized training,group Ⅱ was given regular training.After total 200 cases of laparoscopic assisted colectomy,5cases each doctor,we analyzed the two teams outcome of surgery cooperation.Results Compared with the control group,doctors from observation group were better in the surgery cooperation and the examination.Conclusions Standardized training is very meaningful for the zero-based assistant of laparoscopic gastrointestinal surgery.