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采用肝蒂入路的腹腔镜解剖性肝Ⅵ段切除术

Laparoscopic Anatomic Segment 6 Liver Resection Using the Glissonian Approach.

作者信息

Choi Hanlim, Han Ho-Seong, Yoon Yoo-Seok, Cho Jai Young, Choi YoungRok, Jang Jae Yool

机构信息

*Department of Surgery, Chungbuk National University Hospita, Cheongju-sil †Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine Seongnam-si ‡Department of Surgery, Gyeongsang National University Hospital, Jinju-si, Korea.

出版信息

Surg Laparosc Endosc Percutan Tech. 2017 Jun;27(3):e22-e25. doi: 10.1097/SLE.0000000000000391.

Abstract

INTRODUCTION

Laparoscopic liver resection has become important procedure for malignant liver disease. In this report, we describe the relevant technical maneuvers and perioperative outcomes in laparoscopic anatomic segment 6 liver resection using the Glissonian approach.

PATIENTS AND METHODS

From March 2003 and October 2015, 7 patients who diagnosed hepatocellular carcinoma had undergone laparoscopic anatomic segment 6 liver resection at the single institution. We performed retrospective analysis of the clinical and perioperative outcomes of these patients.

RESULTS

All patients were men with mean age of 62.3 years (range, 49 to 73 y). The mean operation time was 352.8 minutes (range, 180 to 435 min) and there was no case of open conversion. The mean estimated blood loss was 521.4 mL (range, 200 to 800 mL) and intraoperative transfusion needed in 1 patient. There was no postoperative morbidity and mortality. The mean postoperative hospital stay was 7.5 days (range, 5 to 12 d). All patients obtained negative resection margins. There was no patient had developed tumor recurrence during a median follow-up period of 43 months (range, 7 to 60.7 mo).

CONCLUSIONS

Laparoscopic anatomic segment 6 liver resection is a feasible operative procedure, being possible even in patients with limited liver function.

摘要

引言

腹腔镜肝切除术已成为治疗肝脏恶性疾病的重要手术。在本报告中,我们描述了使用Glissonian入路进行腹腔镜解剖性肝段6切除的相关技术操作及围手术期结果。

患者与方法

2003年3月至2015年10月,7例诊断为肝细胞癌的患者在单一机构接受了腹腔镜解剖性肝段6切除术。我们对这些患者的临床及围手术期结果进行了回顾性分析。

结果

所有患者均为男性,平均年龄62.3岁(范围49至73岁)。平均手术时间为352.8分钟(范围180至435分钟),无中转开腹病例。平均估计失血量为521.4毫升(范围200至800毫升),1例患者术中需要输血。无术后并发症及死亡病例。术后平均住院时间为7.5天(范围5至12天)。所有患者切缘阴性。在中位随访期43个月(范围7至60.7个月)内,无患者出现肿瘤复发。

结论

腹腔镜解剖性肝段6切除术是一种可行的手术方式,即使对于肝功能有限的患者也有可能实施。

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