Belli Giulio, Fantini Corrado, D'Agostino Alberto, Cioffi Luigi, Russo Gianluca, Belli Andrea, Limongelli Paolo
Department of General and Hepato-Pancreato-Biliary Surgery, S.M. Loreto Nuovo Hospital, Italy.
Surg Laparosc Endosc Percutan Tech. 2011 Aug;21(4):e166-8. doi: 10.1097/SLE.0b013e3182207d3a.
Single port access laparoscopic redo liver resection for hepatocellular carcinoma on cirrhosis through a single transumbilical skin incision has not been reported in the literature so far.
A wedge resection of segment III lesion with a laparoendoscopic single site surgical incision is described in detail analyzing the technical aspects of the procedure.
There were no intraoperative complications with no intraoperative or perioperative blood transfusions. A Pringle maneuver was not used. Operating time was 130 minutes. The patient had an uneventful postoperative course and was discharged on the second postoperative day. The surgical resection margin was not invaded and had a width of 1.8 cm.
In this case report, we found that liver resection performed by laparoendoscopic single site surgery for peripherally located hepatocellular carcinoma on cirrhosis seems a feasible technique. Such technique is technically demanding and should be undertaken only with proper training and in high volume centers, by surgeons with expertize in both liver and advanced laparoscopic surgery.
目前文献中尚未报道通过单一脐部皮肤切口进行单孔腹腔镜再次肝切除术治疗肝硬化合并肝细胞癌。
详细描述了经腹腔镜单部位手术切口对Ⅲ段病变进行楔形切除术，并分析了该手术的技术要点。
术中无并发症，术中及围手术期均未输血。未使用Pringle手法。手术时间为130分钟。患者术后恢复顺利，术后第二天出院。手术切缘未受侵犯，宽度为1.8厘米。
在本病例报告中，我们发现经腹腔镜单部位手术对肝硬化合并周围型肝细胞癌进行肝切除术似乎是一种可行的技术。这种技术要求较高，应由具备肝脏和高级腹腔镜手术专业知识的外科医生在经过适当培训且具备大量手术经验的中心进行操作。
