Tomuş C, Iancu C, Bălă O, Graur F, Furcea L, Zaharie F, Mocan L, Vlad L
Clinica Chirurgie III, Spitalul de Urgenţă "O. Fodor" Cluj-Napoca.
Chirurgia (Bucur). 2009 May-Jun;104(3):275-80.
The aim of this study was to evaluate the result of liver resection for benign hepatic lesion and to determine the risk factors for postoperative complication. Between January 2001 and December 2006 (6 years), a total of 50 patients with benign hepatic lesion underwent hepatic resection and were retrospectively reviewed. The sex ratio was M/F=31/19 with a mean age of 44 years (range 2-74). The diagnosis was: hydatid cyst in 24 patients (48%); hemangioma in 14 patients (28%), focal nodular hyperplasia (FNH) in 6 (12%), hepatic adenoma in 3 cases (6%), and hepatoblastoma in 3 patients (6%). Fourty patients (80%) had symptoms prior to surgery (mainly abdominal pain). The abnormalities were located in 34 cases on the left liver (II-IV Couinaud segments) and in 16 cases on the right liver (V-VIII Couinaud segments). Twenty-nine patients (58%) underwent atypical resections, 4 underwent left hemihepatectomy (8%), 16 underwent left lobectomy (32%) and 1 patient was treated by segmentectomy (2%). Median operating time was 108 minutes (range 60-220) and the median blood lost was 310 ml range (30- 1500). The morbidity rate was 18% (9 patients). Independent risk factors associated with the development of postoperative complication were intraoperative blood lost more than 1200 ml (p=0,015; OR=1,7) and the operating time more than 150 minutes (p=0,048; OR=1,09). There was no mortality. The mean postoperative hospitalization was 7,86 days with the range 3-23 days.
本研究的目的是评估肝切除术治疗良性肝脏病变的结果,并确定术后并发症的危险因素。在2001年1月至2006年12月(6年)期间,共有50例良性肝脏病变患者接受了肝切除术,并进行了回顾性分析。男女比例为M/F = 31/19,平均年龄44岁(范围2 - 74岁)。诊断结果为:24例(48%)为肝包虫囊肿;14例(28%)为血管瘤,6例(12%)为局灶性结节性增生(FNH),3例(6%)为肝腺瘤,3例(6%)为肝母细胞瘤。40例(80%)患者在手术前有症状(主要为腹痛)。病变位于左肝(Couinaud II - IV段)34例,右肝(Couinaud V - VIII段)16例。29例(58%)患者接受了非典型切除术,4例(8%)接受了左半肝切除术,16例(32%)接受了左叶切除术,1例(2%)接受了肝段切除术。中位手术时间为108分钟(范围60 - 220分钟),中位失血量为310毫升(范围30 - 1500毫升)。发病率为18%(9例)。与术后并发症发生相关的独立危险因素为术中失血量超过1200毫升(p = 0.015;OR = 1.7)和手术时间超过150分钟(p = 0.048;OR = 1.09)。无死亡病例。术后平均住院时间为7.86天,范围为3 - 23天。