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Learning curve of laparoscopic-assisted anorectoplasty for high imperforate anus / 中华实用儿科临床杂志
Chinese Journal of Applied Clinical Pediatrics ; (24): 940-942, 2016.
Article in Chinese | WPRIM | ID: wpr-495244
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.

Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Applied Clinical Pediatrics Year: 2016 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Applied Clinical Pediatrics Year: 2016 Type: Article