@article{oai:ir.kagoshima-u.ac.jp:00014467,
 author = {林, 知実 and 横山, 憲三 and 東, 泰志 and 柳, 政行 and 貴島, 孝 and 大久保, 啓史 and 夏越, 祥次},
 issue = {1-3},
 journal = {鹿児島大学医学雑誌, Medical journal of Kagoshima University},
 month = {Dec},
 note = {腹腔鏡下鼡径ヘルニア手術は技術評価や指導が難しいとされている。今回、ラーニングカーブ、手術の難易度の予測因子について検討した。2014年からの30例を対象とし、手術時間を習熟度と難易度の指標とした。ラーニングカーブはWilcoxon検定で、難易度を予測する 9 因子は重回帰分析で解析した。定型前と比較して、術前難易度予測スコア導入後は有意に手術時間が短縮された。手術時間延長に寄与する因子は、60歳以上、ヘルニア門周囲の癒着、ヘルニア門への嵌入、白色瘢痕、腹膜の厚さ・強度の 5 因子であった。術前難易度予測スコアを用いることにより、難易度に応じた適切な術者が選択でき、手術時間の短縮や合併症の低下に寄与できると考えられた。, Laparoscopic surgery for inguinal hernia has been considered technically difficult and in terms of the surgeons’ procedural competence (learning curve). In a recent study, we investigated the learning curve and the factors that could predict the difficulty of performing laparoscopic surgery for inguinal hernia repair. In 30 such cases performed beginning in 2014, the degree of difficulty and surgeons’ proficiency were evaluated based solely on the operation time. Learning curves were analyzed using the Wilcoxon test. A multiple regression analysis identified nine factors that predicted the degree of difficulty. Based on these results, we developed a new preoperative prediction score. After applying it clinically, we found that the operation time was significantly shorter than that of the previous routine procedure. Five factors contributed to longer operation times: ≥60 years of age; adhesions around the hernial hiatus; incarceration into the hernia hiatus; white scar formation; peritoneal thickness and strength. Since then, we have chosen appropriate operators for this surgery based on their preoperative prediction scores. This selection process has resulted in shorter operation times and fewer surgical complications.},
 pages = {7--17},
 title = {腹腔鏡下鼡径ヘルニア手術（TAPP）における術前難易度予測スコアの有用性について},
 volume = {70},
 year = {2018}
}