基于CUSUM算法的机器人辅助宫颈癌根治术学习曲线研究

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中图分类号 R713文献标识码 A文章编号 2096-7721（2025）07-1150-07

AbstractObjective：To evaluate the learning curveof robot-assisted radical hysterectomy （RRH）forcervical cancerusing the cumulativesummation （CUSUM）algorithm，identifycritical proficiencythresholds，and provide guidancefor clinicalpractice. Methods： Clinicaldataof74cervicalcancerpatients whounderwentRRHperforedbythesamesurgicaleamattheFirstAfiliated HospitalofAirForceMedicalUniversityfromJanuaryO21toOctober2O24wereretrospectivelyanalyzed.Patientseredividedintothe standard surgery group （n=40） and the modified surgery group（ n= 34）. CUSUM analysis was used to plot learning curves， with comparisons of clinicaland peroperativeoutcomes.Results：Allproceduresweresuccesfullycompleted withoutconversiontolaparotomyor perioperative mortality. Total operative time of the standard surgery group was （ 229.72±31.09 ）min，witha Da Vinci robotic surgical system docking time of （32.38±7.30） min and an operative procedure time of （197.32±25.22 ）min respectively. CUSUM analysis indicatedthatwhenthecumulativenumberofsurgeriesreachesthe19thcase，theslopeof thecurveshiftsfrompositivetonegative， markingthesurgicalteam'stransitionfromthelearningandexploratoryphasetotheproficientandstablephase.Theaverageoperative timeforthemodifiedsurgery groupwassignificantlyshorter thanthatforthestandardsurgerygroup（P<0.O5）.Conclusion：Theleaing curve ofRRHforcervicalcaneris19cases，hichissorterthanthatoftraditioallaparoscopicsurgerysuggestingaorapid profciencyacquisitionwihhistechque.ThiadvantagemaybeatrbutedtoestrucuralfeaturesofteDaVincioboticsstete precision of its specialized surgical instruments，and surgeons’ extensive experience.

KeywordsRobot-assisted Surgery; Cervical Cancer; CUSUM Analysis; Learning Curv

1.2手术方法

全球每年新增宫颈癌病例约50万例，占所有新发癌症的 5% ，其中发展中国家负担最重。（剩余14175字）