Factors influencing on difficulty with laparoscopic total extraperitoneal repair according to learning period
Annals of Surgical Treatment and Research
;
: 203-208, 2014.
Artículo
en Inglés
| WPRIM
| ID: wpr-198082
ABSTRACT
PURPOSE:
Laparoscopic total extraperitoneal (TEP) repair of inguinal hernia is technically challenging enough to build high barrier to entry. The purpose of this study was to identify clinical factors influencing technical difficulty with laparoscopic TEP according to learning period.METHODS:
We conducted a retrospective study of 112 adult patients who underwent laparoscopic TEP for unilateral inguinal hernia from January 2009 to September 2013. A technically difficult case was defined as the 70th percentiles or more in the distribution curve of operative time, major complication, or open conversion.RESULTS:
The rate of body mass index (BMI) above 25 kg/m2 was significantly higher in the difficult group than the nondifficult group in the learning period of laparoscopic TEP (57.9% vs. 26.8%, respectively, P = 0.020). However, in the experience period, it revealed no statistical difference with technical difficulty (31.3% vs. 33.3%, respectively, P = 0.882). In multivariate analysis, BMI (> or =25 kg/m2) was identified as a significant independent factor for technical difficulty with laparoscopic TEP in the learning period (odds ratio, 4.572; P = 0.015).CONCLUSION:
Patient's BMI (> or =25 kg/m2) can create technical difficulty with laparoscopic TEP only in the learning period, but not in the experience period. Therefore BMI could be applied as one of the guidelines for patient selection, especially for surgeons in the learning curve of laparoscopic TEP.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Índice de Masa Corporal
/
Análisis Multivariante
/
Estudios Retrospectivos
/
Laparoscopía
/
Selección de Paciente
/
Curva de Aprendizaje
/
Herniorrafia
/
Tempo Operativo
/
Hernia Inguinal
/
Aprendizaje
Tipo de estudio:
Guía de Práctica Clínica
/
Estudio observacional
/
Estudio pronóstico
Límite:
Adulto
/
Humanos
Idioma:
Inglés
Revista:
Annals of Surgical Treatment and Research
Año:
2014
Tipo del documento:
Artículo
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