腹腔镜下射频辅助肝切除术

Laparoscopic liver resection assisted with radiofrequency.

作者信息

Bachellier Philippe, Ayav Ahmet, Pai Madhav, Weber Jean-Christopher, Rosso Edoardo, Jaeck Daniel, Habib Nagy A, Jiao Long R

机构信息

HPB Unit, Hammersmith Hospital, Division of Surgery, Anaesthetics and Intensive Care, Imperial College School of Medicine, Du Cane Rd., London W120NN, UK.

出版信息

Am J Surg. 2007 Apr;193(4):427-30. doi: 10.1016/j.amjsurg.2006.06.046.

DOI:10.1016/j.amjsurg.2006.06.046

PMID:17368282

Abstract

BACKGROUND

Radiofrequency-assisted laparoscopic liver resection is reported.

METHODS

Patients suitable for liver resection were carefully assessed for laparoscopic resection. Patient and intraoperative and postoperative data were prospectively collected and analyzed.

RESULTS

Eighteen patients underwent laparoscopic liver resection. All operations were performed without vascular clamping and consisting of tumorectomy (n = 9), multiple tumoretcomies (n = 2), segmentectomy (n = 2), and bisegmentectomies (n = 2). Mean blood loss was 121 +/- 68 mL, and mean resection was time 167 +/- 45 minutes. There was no need for perioperative or postoperative transfusion of blood or blood products. One patient developed pneumothorax during surgery as a result of direct puncture of pleura with the radiofrequency probe, and 1 patient had transient liver failure and required supportive care after surgery. The mean length of hospital stay was 6.0 +/-1.5 days. At follow-up, those with liver cancer had no recurrence.

CONCLUSIONS

Radiofrequency-assist laparoscopic liver resection can decrease the risk of intraoperative bleeding and blood transfusion.

摘要

背景

报道了射频辅助腹腔镜肝切除术。

方法

对适合肝切除的患者进行仔细评估以确定是否适合腹腔镜切除。前瞻性收集并分析患者以及术中、术后的数据。

结果

18例患者接受了腹腔镜肝切除术。所有手术均在未进行血管阻断的情况下进行，包括肿瘤切除术（n = 9）、多次肿瘤切除术（n = 2）、肝段切除术（n = 2）和双肝段切除术（n = 2）。平均失血量为121±68毫升，平均切除时间为167±45分钟。无需围手术期或术后输血或使用血制品。1例患者在手术期间因射频探头直接穿刺胸膜而发生气胸，1例患者出现短暂性肝衰竭，术后需要支持治疗。平均住院时间为6.0±1.5天。随访时，肝癌患者无复发。