腹腔镜下肝切除术围手术期手术技巧对预后的影响

IF 0.9 Q4 ORTHOPEDICS Asian Journal of Endoscopic Surgery Pub Date : 2024-11-28 DOI:10.1111/ases.13413
Taku Kimura, Hiroyuki Nitta, Hirokatsu Katagiri, Shoji Kanno, Akira Umemura, Daiki Takeda, Taro Ando, Satoshi Amano, Toma Kawashima, Koji Kikuchi, Shuta Kuchida, Akira Sasaki
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引用次数: 0

摘要

腹腔镜肝切除术(LLR)是一项困难的手术,需要术者有很高的技术水平。内镜医师在确保合适的手术范围方面发挥着重要作用。这是第一个关注腹腔镜医师在LLR围手术期预后中的技能的研究。材料与方法2018年4月至2023年3月期间接受LLR的患者纳入本研究。检查人员被分为专家组(≥10个LLR程序作为检查人员)和初学者组(<; 10个LLR程序作为检查人员)。回顾性分析两组间内镜师技能对LLR围手术期疗效的影响。除了列出基线特征和围手术期结果外,本研究还通过视频记录列出术中手术操作因素作为新的尝试。结果两组患者的基线特征和围手术期结局无显著差异。在新手组中,由于Pringle操作过程中的范围操作错误而导致手术中断的时间明显更长(71 vs. 198 s, p < 0.001)。结论经验不足的小内眦镜术者对内眦镜的操作有时会阻碍手术的进展。内镜师的技能可能会增加外科医生的心理负担,延长手术时间。
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Effects of the Scopist's Skills on the Perioperative Outcomes of Laparoscopic Liver Resection

Introduction

Laparoscopic liver resection (LLR) is a difficult procedure that requires the scopist to have a high skill level. Scopists play an important role in ensuring an appropriate surgical field. This is the first study that focuses on the scopist's skills in perioperative outcomes of LLR.

Materials and Methods

Patients who underwent LLR from April 2018 to March 2023 were included in this study. The scopists were separated into expert (≥ 10 LLR procedures as a scopist) and beginner (< 10 LLR procedures as a scopist) groups. The effects of the scopists' skills on the perioperative outcomes of LLR between the two groups were examined retrospectively. In addition to listing baseline characteristics and perioperative outcomes, this study viewed video recordings to list intraoperative surgical manipulation factors as new attempts.

Results

No significant differences were observed in the baseline characteristics or perioperative outcomes between the two groups. The duration of the time during which the surgical procedure was interrupted due to scope operation errors during the Pringle maneuver was significantly longer in the beginner group (71 vs. 198 s, p < 0.001).

Conclusion

The scope manipulation by the less experienced LLR scopists sometimes hindered the progress of the surgery. The scopist's skills may lead to an increased psychological burden on the surgeon and prolonged operative times.

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CiteScore
2.00
自引率
10.00%
发文量
129
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