Chen Jian-Cong, Zhang Rong-Xin, Chen Min-Shan, Xu Li, Chen Jin-Bin, Yang Ke-Li, Zhang Yao-Jun, Zhou Zhong-Guo
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China.
Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, P. R. China.
Chin J Cancer. 2017 Mar 20;36(1):31. doi: 10.1186/s40880-017-0190-y.
Laparoscopic hepatectomy for hepatocellular carcinoma (HCC) located in segment VI, VII, or VIII of the liver is usually difficult because of poor operative exposure, due to the unique anatomical structure. In this study, we evaluated the practice of laparoscopic hepatectomy with the left jackknife position for patients with HCC located in segment VI, VII, or VIII.
A total of 10 patients were enrolled to undergo laparoscopic hepatectomy with the left jackknife position. Tumors located in segment VI, VII, or VIII were assessed by preoperative dynamic computed tomography or magnetic resonance imaging. Operation time, intraoperative blood loss, postoperative fasting time, postoperative drainage time, major postoperative complications, and duration of postoperative hospital stay were recorded.
All surgeries were successfully completed. None of the patients required conversion to open surgery during the procedure, and no serious postoperative complications were observed. The median tumor size was 31 mm (range 23-41 mm) in diameter, the mean operation time was 166 ± 38 min, the mean intraoperative blood loss was 220 ± 135 mL, and the median postoperative hospital stay was 4 days (range 2-7 days).
For HCC located in segment VI, VII, or VIII, laparoscopic hepatectomy with this novel position-the left jackknife position-is safe and effective during tumor resection by exposing a sufficient operating field. Trial registration ClinicalTrials.gov ID: NCT02809287.
由于肝脏独特的解剖结构，位于肝Ⅵ、Ⅶ或Ⅷ段的肝细胞癌（HCC）行腹腔镜肝切除术通常因手术暴露不佳而困难。在本研究中，我们评估了对于位于肝Ⅵ、Ⅶ或Ⅷ段的HCC患者采用左侧折刀位行腹腔镜肝切除术的实践效果。
共纳入10例患者接受左侧折刀位腹腔镜肝切除术。术前通过动态计算机断层扫描或磁共振成像评估位于肝Ⅵ、Ⅶ或Ⅷ段的肿瘤。记录手术时间、术中出血量、术后禁食时间、术后引流时间、术后主要并发症及术后住院时间。
所有手术均成功完成。术中无患者需要转为开放手术，且未观察到严重的术后并发症。肿瘤直径中位数为31mm（范围23 - 41mm），平均手术时间为166 ± 38分钟，平均术中出血量为220 ± 135mL，术后住院时间中位数为4天（范围2 - 7天）。
对于位于肝Ⅵ、Ⅶ或Ⅷ段的HCC，通过暴露足够的手术视野，采用这种新的体位——左侧折刀位行腹腔镜肝切除术在肿瘤切除过程中是安全有效的。试验注册ClinicalTrials.gov标识符：NCT02809287。
