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Learning Curve for a Laparoscopic Appendectomy by a Surgical Trainee

대한대장항문학회지 2010년 26권 5호 p.324 ~ 328
 ( Kim Song-Yi ) - 강원대학교 의과대학 외과학교실

 ( Hong Sung-Gun ) - 강원대학교 의과대학 외과학교실
노혜린 ( Roh Hye-Rin ) - 강원대학교 의과대학 외과학교실
 ( Park Seong-Bae ) - 강원대학교 의과대학 외과학교실
김양희 ( Kim Yang-Hee ) - 강원대학교 의과대학 외과학교실
채기봉 ( Chae Gi-Bong ) - 강원대학교 의과대학 외과학교실

Abstract


Purpose The laparoscopic appendectomy has been a basic part of the principal of a more complex laparoscopic technique for the surgical trainee. As the number of laparoscopic appendectomies performed by surgical trainees has increased, we are trying to check the stability of, which is controversial, and the learning curve associated with a laparoscopic appendectomy.

Methods We studied the demographics, histologic diagnoses, operative time, the number of complicated cases, and hospital duration of one hundred and three patients who underwent an open appendectomy (group A, 53) or a laparoscopic appendectomy (group B, 50) retrospectively through a review of their medical records. The learning curve for the laparoscopic appendectomy was established through the moving average and ANOVA methods.

Results There were no differences in the operative times (A, 64.15 ± 29.88 minutes; B, 58.2 ± 20.72 minutes; P-value, 0.225) and complications (A, 11%; B, 6%; P-value, 0.34) between group A and group B. Group B was divided into group C who underwent the operation in the early period (before the learning curve) and group D who underwent the operation in the later period (after the learning curve). The average operative time for group C was 66.83 ± 21.55 minutes, but it was 45.25 ± 10.19 minutes for group D (P-value < 0.0001). Although this difference was statistically significant, no significant difference in the complication rate was observed between the two groups.

Conclusion A laparoscopic appendectomy, compared with an open appendectomy, performed by a surgical trainee is safe. In this study, the learning curve for a laparoscopic appendectomy was thirty cases.

키워드

Appendectomy; Laparoscopy; Learning curve
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