Beppu Toru, Ishiko Takatoshi, Chikamoto Akira, Komori Hiroyuki, Masuda Toshiro, Hayashi Hiromitsu, Okabe Hirohisa, Otao Ryu, Sugiyama Shinichi, Nasu Jiro, Horino Kei, Takamori Hiroshi, Baba Hideo
Department of Gastroenterology Surgery, Kumamoto University, Kumamoto, Japan.
Hepatogastroenterology. 2012 Mar-Apr;59(114):542-5. doi: 10.5754/hge09737.
BACKGROUND/AIMS: To clarify the clinical benefits of the maneuver in right-side hepatectomy.
Eighty-one patients with liver tumor (54 hepatocellular carcinoma, 17 metastatic liver tumor and 10 other tumors) treated with a right-side hepatectomy were prospectively analyzed. The patients were divided into the following three groups: a conventional approach (group A, n=21); liver dissection under the hanging maneuver after liver mobilization (group B, n=19) and liver dissection under the hanging maneuver prior to liver mobilization (group C, n=41).
The liver hanging maneuver was safely performed in all the patients in groups B and C. Tumor size had a significantly positive correlation with the amount of intraoperative blood loss (R=0.52, p<0.05) in group A only. The patients in groups B and C had a significantly lower intraoperative use of blood loss (both p<0.01), operation time (p<0.05 and p<0.01) and the frequency of blood product (both p<0.05), in comparison to group A, respectively. The postoperative morbidity and the mortality rates were similar in the three groups.
Liver hanging maneuver is a safe procedure, which can decrease intraoperative blood loss and administration of blood product in right-side hepatectomy.
背景/目的:阐明该操作在右半肝切除术中的临床益处。
对81例行右半肝切除术的肝肿瘤患者(54例肝细胞癌、17例肝转移瘤和10例其他肿瘤)进行前瞻性分析。患者分为以下三组:传统方法组(A组,n = 21);肝脏游离后悬吊法肝门解剖组(B组,n = 19)和肝脏游离前悬吊法肝门解剖组(C组,n = 41)。
B组和C组所有患者均安全实施了肝脏悬吊操作。仅在A组中,肿瘤大小与术中失血量呈显著正相关(R = 0.52,p < 0.05)。与A组相比,B组和C组患者术中失血量的使用量(均p < 0.01)、手术时间(p < 0.05和p < 0.01)及血制品使用频率(均p < 0.05)均显著更低。三组患者术后发病率和死亡率相似。
肝脏悬吊操作是一种安全的手术方法,可减少右半肝切除术中的术中失血量及血制品的使用。