水刀解剖在开腹和腹腔镜肝切除术中的应用。
The use of water-jet dissection in open and laparoscopic liver resection.
机构信息
Surgical Department of Visceral, Thoracic and Vascular Surgery, Amper-Klinikum Dachau, Dachau, Germany.
出版信息
HPB (Oxford). 2008;10(4):275-80. doi: 10.1080/13651820802167706.
BACKGROUND
We intend to give an overview of our experiences with the implementation of a new dissection technique in open and laparoscopic surgery.
METHODS
Our database comprises a total of 950 patients who underwent liver resection. Three hundred and fifty of them were performed exceptionally with the water-jet dissector. Forty-one laparoscopic partial liver resections were accomplished.
RESULTS
Using the water-jet dissection technique it was possible to reduce the blood loss, the Pringle- and resection time in comparison to CUSA and blunt dissection. In the last five years we could reduce the Pringle-rate from 48 to 6% and the last 110 liver resections were performed without any Pringle's manoeuvre. At the same time, the transfusion-rate decreased from 1.86 to 0.46 EC/patient. In oncological resections, the used dissection technique had no influence on long-time survival.
CONCLUSIONS
The water-jet dissection technique is fast, feasible, oncologically safe and can be used in open and in laparoscopic liver surgery.
背景
我们旨在概述我们在开放式和腹腔镜手术中实施新解剖技术的经验。
方法
我们的数据库包括总共 950 名接受肝切除术的患者。其中 350 例采用水刀解剖器进行特殊手术。完成了 41 例腹腔镜部分肝切除术。
结果
与 CUSA 和钝性解剖相比，使用水射流解剖技术可以减少出血量、普雷林时间和切除时间。在过去的五年中，我们可以将普雷林率从 48%降至 6%，并且最后 110 例肝切除术无需进行普雷林操作。同时，输血率从 1.86 降至 0.46 EC/患者。在肿瘤切除术方面，所使用的解剖技术对长期生存率没有影响。
结论
水射流解剖技术快速、可行、具有肿瘤安全性，可用于开放式和腹腔镜肝手术。
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