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腹腔镜下肝癌切除术:57例患者的三年研究

Laparoscopic liver resection for hepatocellular carcinoma: a three-year study of 57 Patients.

作者信息

Choi Nam-Kyu, Kim Ki-Hun, Jung Dong-Hwan, Yu Young-Dong, Jung Sung-Won, Namkoong Jung-Man, Yoon Sam-Youl, Lee Sung-Gyu

机构信息

Department of Surgery, Chosun University Hospital, Gwangju, Korea.

出版信息

Hepatogastroenterology. 2013 Jan-Feb;60(121):144-8. doi: 10.5754/hge12962.

Abstract

BACKGROUND/AIMS: Laparoscopic liver resection has become an increasingly popular operation but is still in relatively limited use. Here we evaluate the intermediate-term results of laparoscopic liver resection.

METHODOLOGY

Fifty-seven patients with HCC underwent laparoscopic liver resection at the Asan Medical Center. Data for all resections were recorded and analyzed retrospectively. Patient gender, age, preoperative laboratory data, presence of cirrhosis, blood loss, hospital stay length, pathology report, tumor site and size, resection type, resection margin, morbidity and mortality were assessed.

RESULTS

The mean patient age ranged from 35-74 years and the mean tumor size from 0.8-5.5 cm. Tumors were located in the left lateral lobe, left medial lobe and right lobe. Left lateral sectionectomy was performed in 32 cases, partial hepatectomy in 11, left hepatectomy in 6, right hepatectomy in 2, laparoscopy-assisted right hepatectomy in 2 and laparoscopy-assisted right posterior sectionectomy in 4. Median operation time ranged from 95-380 min while median blood loss ranged from 150-800 mL. The mean resection margin was 2.08±1.68 cm with no in-hospital mortalities. Return to normal diet was achieved on average at 1.83±0.8 days; mean hospital stay ranged from 3 to 17 days. The 3-year overall and disease-free survival rates were 81% and 71%, respectively.

CONCLUSIONS

Laparoscopic liver resection for HCC is feasible, safe and promising for a select group of patients. Its benefits include short hospital stays, rapid return to normal diet, full mobility and minimal morbidity with acceptable oncological parameters.

摘要

背景/目的:腹腔镜肝切除术已成为一种越来越受欢迎的手术,但应用仍相对有限。在此,我们评估腹腔镜肝切除术的中期结果。

方法

57例肝癌患者在峨山医学中心接受了腹腔镜肝切除术。对所有切除术的数据进行回顾性记录和分析。评估患者的性别、年龄、术前实验室数据、肝硬化情况、失血量、住院时间、病理报告、肿瘤部位和大小、切除类型、切缘、发病率和死亡率。

结果

患者平均年龄为35 - 74岁,肿瘤平均大小为0.8 - 5.5厘米。肿瘤位于左外叶、左内叶和右叶。32例行左外叶切除术,11例行部分肝切除术,6例行左肝切除术,2例行右肝切除术,2例行腹腔镜辅助右肝切除术,4例行腹腔镜辅助右后段切除术。中位手术时间为95 - 380分钟,中位失血量为150 - 800毫升。平均切缘为2.08±1.68厘米,无院内死亡病例。平均1.83±0.8天恢复正常饮食;平均住院时间为3至17天。3年总生存率和无病生存率分别为81%和71%。

结论

对于特定的一组患者,腹腔镜肝癌切除术是可行、安全且有前景的。其优点包括住院时间短、快速恢复正常饮食、完全活动能力以及发病率低且肿瘤学参数可接受。

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