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穿皮内镜腰椎切除术是学习单侧双门内镜技术所必需的吗?

Yiwei Xie¹, Yicheng Chen¹, Qifeng Yu¹

¹Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Frontiers in surgery

|April 28, 2025

概括

通过皮肤内镜腰椎切除术 (PELD) 之前的经验显著加快了单侧双门内镜 (UBE) 手术的学习曲线. 此前的PELD手术经验也导致手术时间缩短,并发症减少.

科学领域:

脊柱外科手术脊柱外科手术
最少侵入性手术的方法
外科教育的外科教育

背景情况:

单侧双门内镜 (UBE) 是腰椎手术的一个新兴的微创手术技术.
了解影响新手术技术学习曲线的因素对于有效的培训和患者安全至关重要.

研究的目的:

评估先前的穿皮内镜腰椎切除术 (PELD) 经验对UBE技术的学习曲线的影响.
为了比较之前有或没有PELD经验的外科医生之间实现UBE熟练程度所需的病例数量.

主要方法:

总共分析了200名接受单段UBE手术的患者.
四名外科医生被分为两组:A组 (有先前的PELD经验) 和B组 (没有先前的PELD经验).
累积总和分析 (CUSUM) 用于评估学习曲线,熟练程度定义为<80分钟的手术时间. 临床结果 (修改的Macnab,VAS-leg,VAS-back,ODI) 在术后12个月被评估.

主要成果:

具有先前PELD经验的外科医生 (A组) 与没有 (B组,25-27例) 相比,需要显著减少的病例 (17-18) 才能达到UBE熟练程度.
在12个月后,两组之间没有观察到患者报告的临床结果的显著差异.
与B组 (14) 相比,A组 (5) 的并发症率较低.

结论:

之前的PELD手术经验显著促进了UBE技术的学习和采用.
PELD的经验与更短的学习曲线,更短的手术时间和UBE手术中更低的并发症率有关.
这表明,PELD经验是外科医生学习UBE的宝贵资产.

关键词:

累计总和 (CUSUM) 是指累计的总和.学习曲线分析学习曲线分析穿皮内镜腰椎间盘切除术 (PELD)手术并发症手术并发症一边双门内镜 (UBE)

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