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腹腔镜肝脏肿瘤手术。

Laparoscopic surgery of liver tumors.

机构信息

Department of General, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany,

出版信息

Langenbecks Arch Surg. 2013 Oct;398(7):931-8. doi: 10.1007/s00423-013-1117-y. Epub 2013 Sep 18.

Abstract

INTRODUCTION

Despite initial concerns regarding safety and oncological adequacy, the use of laparoscopic liver resections for benign and malignant diseases has spread worldwide. As in open liver surgery, anatomical orientation and the ability to control intraoperative challenges as bleeding have to be combined with expertise in advanced laparoscopic techniques.

METHODS

In this review, we provide an overview regarding the literature on laparoscopic liver resection for benign and malignant liver tumors with the aim to discuss the current standards and define remaining challenges. Although numerous case series and meta-analyses have addressed the evolving field of laparoscopic liver surgery recently, data from randomized controlled trials are still not available.

RESULTS AND CONCLUSIONS

Laparoscopic liver resection is feasible and safe in selected patients and experienced hands. Even major liver resections can be performed laparoscopically. The minimal invasive approach offers benefits in perioperative short-term outcome without compromising oncological outcomes compared to open liver resections. Further randomized trials are needed to formally prove these statements and to define the optimal indication and techniques for the individual patient.

摘要

简介

尽管最初对安全性和肿瘤学充分性存在担忧,但腹腔镜肝切除术已在全球范围内用于治疗良性和恶性疾病。与开放性肝手术一样,解剖定位和控制术中出血等挑战的能力必须与先进的腹腔镜技术专业知识相结合。

方法

在这篇综述中,我们对腹腔镜肝切除术治疗良性和恶性肝肿瘤的文献进行了概述,旨在讨论当前的标准并确定仍存在的挑战。尽管最近有许多病例系列和荟萃分析涉及腹腔镜肝外科的不断发展领域,但仍没有随机对照试验的数据。

结果和结论

在有选择的患者和有经验的医生手中,腹腔镜肝切除术是可行和安全的。即使是大的肝切除术也可以通过腹腔镜完成。与开放性肝切除术相比,微创方法在围手术期短期结果方面具有优势,而不会影响肿瘤学结果。需要进一步的随机试验来正式证明这些观点,并为每位患者确定最佳的适应证和技术。

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