gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2020-19-2-62-68gnck-1583Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESКРИВАЯ ОБУЧЕНИЯ ТРАНСАНАЛЬНОЙ ТОТАЛЬНОЙ МЕЗОРЕКТУМЭКТОМИИTRANSANAL TOTAL MESORECTAL EXCISION LEARNING CURVEКазиеваЛ. Ю.KazievaL. Yu.

Казиева Людмила Юрьевна

ул. Саляма Адиля, д. 2, Москва, 123423тел.: +7 (499) 199-25-54 

Moscow

kazievalyu@gmail.comЧернышовС. В.ChernyshovS. V.

Москва

Moscow

РыбаковЕ. Г.MainovskayaO. A.

Москва

Moscow

МайновскаяО. А.RybakovE. G.

Москва

Moscow

ФГБУ «НМИЦ колопроктологии имени А.Н. Рыжих» Минздрава РоссииРоссияRyzhikh National Medical Research Centre for Coloproctology of the Ministry of Health of RussiaRussian Federation2020020620201926268Copyright © Казиева Л.Ю., Чернышов С.В., Рыбаков Е.Г., Майновская О.А., 20202020Казиева Л.Ю., Чернышов С.В., Рыбаков Е.Г., Майновская О.А.Kazieva L.Y., Chernyshov S.V., Mainovskaya O.A., Rybakov E.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/1583

ЦЕЛЬ: Оценка кривой обучения трансанальной тотальной мезоректумэктомии (ТА ТМЭ).ПАЦИЕНТЫ И МЕТОДЫ: В исследование включено 65 пациентов с раком нижне-, среднеампулярного отдела прямой кишки сT2-T4aN02bM0-1.РЕЗУЛЬТАТЫ: При общей длительности вмешательства 272,4±50,8 (190-400) минуты после 17 случая продолжительность вмешательства стала убывать. При длительности трансанального этапа 84,9±43,2 (40-200) минуты этот показатель снизился после 20 случая. Частота интраоперационных осложнений составила 8(12,3%), послеоперационных – 25(38,4%) случая. При этом снижение этих показателей с приобретением опыта произошло к 18 и 20 случаям, соответственно. Частота конверсии составила 2(3,0%) случая, однако уже после 6 случая конверсии не отмечалось. Grade 1 препараты были выявлены у 9(13,8%) пациентов, при этом, согласно анализу кривой обучения, этот показатель снизился после 16 случая.ЗАКЛЮЧЕНИЕ: Согласно полученным данным, кривая обучения трансанальной тотальной мезоректумэктомии в условиях специализированной клиники, в среднем, составляет 16-20 случаев.

AIM: to evaluate transanal total mesorectal excision (TA TME) learning curve.PATIENTS AND METHODS: sixty-five patients with mid- and low сT2-T4aN0-2bM0-1 rectal cancer were included.RESULTS: mean total operating time was 272.4±50.8 (190-400) minutes and after 17 th case it has decreased. Mean operating time of transanal phase was 84.9±43.2 (40-200) minutes and after 20 th case it has also decreased. The rate of intraoperative complications was 8 (12.3%), postoperative morbidity – 25 (38.4%) cases. These indicators have decreased after 18 th and 20 th cases respectively. Conversion rate was 2 (3.0%) cases and have decreased after 6 th case. Grade 1 specimens were revealed in 9 (13.8%) cases and have decreased after 16 th case.CONCLUSION: TA TME learning curve in high-volume colorectal unit is 16-20 cases.

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The authors declare that there are no conflicts of interest present.