Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Queen Mary Hospital, Hong Kong, China.
World J Gastroenterol. 2010 Jan 28;16(4):526-30. doi: 10.3748/wjg.v16.i4.526.
Conventional hepatectomy is an effective way to treat hepatocellular carcinoma. However, it is invasive and stressful. The use of laparoscopy in hepatectomy, while technically demanding, reduces surgical invasiveness and stressfulness but still achieves complete resection with adequate margins. Compared with conventional hepatectomy, laparoscopic hepatectomy provides a better chance and situation for further surgery in the case of recurrence of hepatocellular carcinoma. Even aged patients can successfully endure repeated hepatectomy using laparoscopy, as shown in the present report. This report presents a case of repeated laparoscopic hepatectomy treating hepatocellular carcinoma and its recurrence in an aged patient having cirrhosis, a disease causing extra difficulty for performing laparoscopic hepatectomy. The report also describes techniques of the operation and displays characteristic results of laparoscopic hepatectomy such as smaller wounds, less blood loss, less pain, less scars and adhesion, shorter postoperative hospital stay, and faster recovery.
传统的肝切除术是治疗肝细胞癌的有效方法。然而,它具有侵袭性和应激性。在肝切除术中使用腹腔镜技术虽然技术要求较高,但可以降低手术的侵袭性和应激性,同时仍能实现足够切缘的完全切除。与传统的肝切除术相比,腹腔镜肝切除术在肝细胞癌复发的情况下提供了更好的进一步手术机会和情况。即使是老年患者,也可以成功地耐受腹腔镜重复肝切除术,本报告中就有这样的病例。本报告介绍了一例高龄合并肝硬化的肝细胞癌患者,采用重复腹腔镜肝切除术治疗肝癌及其复发。该病例增加了腹腔镜肝切除术的难度,报告还描述了手术技术,并展示了腹腔镜肝切除术的特征性结果,如较小的切口、较少的出血、较轻的疼痛、较少的疤痕和粘连、较短的术后住院时间以及更快的恢复。