【摘要】 目的:探讨左侧卧位下腹腔镜肝S7段切除术的学习曲线，以期为临床推广该术式提供参考依据。方法:回顾分析2019年6月至2023年10月为65例患者采用左侧卧位行腹腔镜肝S7段切除术的临床资料，观察手术时间、术中出血量、术后住院时间等指标，应用累计和法得出左侧卧位下腹腔镜肝S7段除术的学习曲线，并分析曲线各阶段的相关数据。结果:手术时间平均(163.94±13.50)min,术中出血量200(100,405)mL,术后住院10(7.5,14)d。手术例数达到18例时，学习曲线趋于平缓；37例时，学习曲线开始下降。前期与后期手术时间[(181.56±7.63)min vs.(152.72±5.81)min]、出血量[437.5(360,496.25)mL vs. 100(80,200)mL]差异有统计学意义(P<0.001),术后住院时间差异无统计学意义[11(8.75,16)d vs. 10(7.5,14)d,P=0.202]。结论:对于经验丰富的外科医师，由传统平卧位过渡至左侧卧位行腹腔镜肝S7段切除术的学习过程呈现三个典型阶段，初步掌握该术式约需18例手术，达到稳定熟练阶段需累积37例手术经验。更多还原

【Abstract】 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 observed.The cumulative sum method was used to establish the learning curve of laparoscopic S7 segmentectomy in the left lateral decubitus 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 reached 37 cases.There were significant differences in operative time [(181.56±7.63)min vs.(152.72±5.81)min] and intraoperative 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.更多还原