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首例“一百例腹腔镜肝切除术”的单中心经验

A single centre experience of first "one hundred laparoscopic liver resections".

作者信息

Rehman S, John S K P, French J J, Manas D M, White S A

机构信息

Department of Hepatobiliary and Transplantation Surgery, The Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.

Department of Hepatobiliary and Transplantation Surgery, The Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK ; The Liver Research Group, The University of Newcastle, Leech Building, Framlington Place, Newcastle upon Tyne NE1 7RP, UK.

出版信息

HPB Surg. 2014;2014:930953. doi: 10.1155/2014/930953. Epub 2014 Feb 11.

Abstract

Background. Laparoscopic liver resection (LLR) has emerged as an alternative procedure to open liver resection in selected patients. The purpose of this study was to describe our initial experience of 100 patients undergoing LLR. Methods. We analysed a prospectively maintained hepatobiliary database of 100 patients who underwent LLR between August 2007 and August 2012. Clinicopathological data were reviewed to evaluate surgical outcomes following LLR. Results. The median age was 64 and median BMI 27. Patients had a liver resection for either malignant lesions (n = 74) or benign lesions (n = 26). Commonly performed procedures were segmentectomy/metastectomy (n = 55), left lateral sectionectomy (LLS) (n = 26), or major hepatectomy (n = 19). Complete LLR was performed in 84 patients, 9 were converted to open and 7 hand-assisted. The most common indications were CRLM (n = 62), followed by hepatic adenoma (n = 9) or hepatocellular carcinoma (n = 7). The median operating time was 240 minutes and median blood loss was 250 mL. Major postoperative complications occurred in 9 patients. The median length of stay (LOS) was 5 days. One patient died within 30 days of liver resection. Conclusions. LLR is a safe and oncologically feasible procedure with comparable short-term perioperative outcomes to the open approach. However, further studies are necessary to determine long-term oncological outcomes.

摘要

背景。在特定患者中,腹腔镜肝切除术(LLR)已成为开腹肝切除术的替代手术方式。本研究的目的是描述我们对100例行LLR患者的初步经验。方法。我们分析了一个前瞻性维护的肝胆数据库,该数据库包含2007年8月至2012年8月期间接受LLR的100例患者。回顾临床病理数据以评估LLR后的手术结果。结果。中位年龄为64岁,中位体重指数为27。患者因恶性病变(n = 74)或良性病变(n = 26)接受肝切除术。常见的手术方式为肝段切除术/转移瘤切除术(n = 55)、左外侧肝段切除术(LLS)(n = 26)或肝大部切除术(n = 19)。84例患者完成了LLR,9例转为开腹手术,7例采用手辅助手术。最常见的适应证为结直肠癌肝转移(CRLM)(n = 62),其次为肝腺瘤(n = 9)或肝细胞癌(n = 7)。中位手术时间为240分钟,中位失血量为250毫升。9例患者发生了主要术后并发症。中位住院时间(LOS)为5天。1例患者在肝切除术后30天内死亡。结论。LLR是一种安全且在肿瘤学上可行的手术,围手术期短期结果与开腹手术相当。然而,需要进一步研究以确定长期肿瘤学结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca24/3942341/65537956f624/HPB2014-930953.001.jpg

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