左侧卧位下腹腔镜肝S7段切除术学习曲线分析OA

Objective:To investigate the learning curve of laparoscopic liver resection of the seventh segment in the left lateral decubitus position,so as to provide a reference for the clinical promotion of this surgical method.Methods:A retrospective analysis was performed on clinical data of 65 patients who underwent laparoscopic liver resection of segment S7 in the left lateral decubitus position between Jun.2019 and Oct.2023.Indicators including operative time,intraoperative blood loss,and postoperative hospital stay were ob-served.The cumulative sum method was used to establish the learning curve of laparoscopic S7 segmentectomy in the left lateral decubi-tus position,and the relevant data from different phases of the curve were analyzed.Results:The mean operative time was(163.94±13.50)min,the median intraoperative blood loss was 200(100,405)mL,and the postoperative hospital stay was 10(7.5,14)d.The learning curve tended to be flat when the number of surgeries reached 18 cases,and began to decline when the number of surgeries reached37 cases.There were significant differences in operative time[(181.56±7.63)min vs.(152.72±5.81)min]and intraopera-tive blood loss[437.5(360,496.25)mL vs.100(80,200)mL]between the early stage and the late stage(P<0.001),while there was no significant difference in postoperative hospital stay between the two phases[11(8.75,16)d vs.10(7.5,14)d,P=0.202].Conclusions:For experienced surgeons,the learning process of transitioning from the traditional supine position to the left lateral decu-bitus position for laparoscopic S7 segmentectomy presents three typical stages.Preliminary mastery of this surgical method requires about 18 surgeries,and reaching a stable and proficient stage requires accumulating 37 cases of surgical experience.