Jiao Long R, Ayav Ahmet, Navarra Giuseppe, Sommerville Craig, Pai Madhava, Damrah Osama, Khorsandi Shrin, Habib Nagy A
HPB Unit, Hammersmith Hospital, London, UK.
Surgery. 2008 Nov;144(5):770-4. doi: 10.1016/j.surg.2008.08.005. Epub 2008 Sep 19.
Radiofrequency has been used as a tool for liver resection since 2002. A new laparoscopic device is reported in this article that assists liver resection laparoscopically.
From October 2006 to the present, patients suitable for liver resection were assessed carefully for laparoscopic resection with the laparoscopic Habib Sealer (LHS). Detailed data of patients resected laparoscopically with this device were collected prospectively and analyzed.
In all, 28 patients underwent attempted laparoscopic liver resection. Four cases had to be converted to an open approach because of extensive adhesions from previous colonic operations. Twenty-four patients completed the procedure comprising tumorectomy (n = 7), multiple tumoretcomies (n = 5), segmentectomy (n = 3), and bisegmentectomies (n = 9). Vascular clamping of portal triads was not used. The mean resection time was 60 +/- 23 min (mean +/- SD), and blood loss was 48 +/- 54 mL. None of the patients received any transfusion of blood or blood products perioperatively or postoperatively. Postoperatively, 1 patient developed severe exacerbation of asthma that required steroid therapy, and 1 other patient had a transient episode of liver failure that required supportive care. The mean duration of hospital stay was 5.6 +/- 2 days (mean +/- SD). At a short-term follow up, no recurrence was detected in patients with liver cancer.
Laparoscopic liver resection can be performed safely with this new laparoscopic liver resection device with a significantly low risk of intraoperative bleeding or postoperative complications.
自2002年以来,射频已被用作肝切除的一种工具。本文报道了一种新型腹腔镜设备,它可辅助进行腹腔镜肝切除。
从2006年10月至今,对适合肝切除的患者使用腹腔镜Habib密封器(LHS)仔细评估是否适合进行腹腔镜切除。前瞻性收集并分析使用该设备进行腹腔镜切除患者的详细数据。
共有28例患者尝试进行腹腔镜肝切除。4例因既往结肠手术导致广泛粘连而不得不转为开放手术。24例患者完成了手术,包括肿瘤切除术(n = 7)、多次肿瘤切除术(n = 5)、肝段切除术(n = 3)和双肝段切除术(n = 9)。未使用门静脉三联征血管夹闭。平均切除时间为60±23分钟(平均值±标准差),失血量为48±54毫升。所有患者在围手术期或术后均未接受任何输血或血液制品。术后,1例患者哮喘严重加重,需要类固醇治疗,另1例患者出现短暂性肝功能衰竭,需要支持治疗。平均住院时间为5.6±2天(平均值±标准差)。在短期随访中,肝癌患者未检测到复发。
使用这种新型腹腔镜肝切除设备可安全地进行腹腔镜肝切除,术中出血或术后并发症风险显著较低。