Kisiel Aaron, Vass David G, Navarro Alex, John Annie K, Isaac Johh, Marudanayagam Ravi, Mirza Darius F, Muiesan Paolo, Roberts Keith, Sutcliffe Robert P
Liver Unit, Queen Elizabeth Hospital, Birmingham, UK.
Surg Laparosc Endosc Percutan Tech. 2017 Aug;27(4):e80-e82. doi: 10.1097/SLE.0000000000000441.
Laparoscopic fenestration is the treatment of choice for symptomatic liver cysts. Despite the benefits of minimally invasive surgery, there is limited data on long-term outcomes after laparoscopic fenestration, in terms of symptom recurrence and quality of life. The purpose of this study was to evaluate long-term patient-reported outcomes and satisfaction following this procedure.
All patients who underwent laparoscopic liver cyst fenestration in a single center between 2001 and 2012 were identified from a prospectively maintained database. Long-term patient-reported outcomes including symptom relief and quality of life were prospectively evaluated by a structured telephone interview.
A total of 98 patients underwent laparoscopic liver cyst fenestration. The median follow-up was 62 months (range, 22 to 173 mo). Follow-up data was available in 48 patients. Four patients developed radiologically confirmed evidence of recurrence with 3 undergoing further surgery. No mortality was reported in the series. Four complications occurred and the median postoperative length of hospital stay was 2 days (range, 1 to 7 d). Thirty-nine patients received immediate symptomatic relief with 98% reporting long-term satisfaction.
Laparoscopic liver cyst fenestration is associated with low morbidity and long-term alleviation of symptoms. This should be considered the treatment modality of choice in managing patients with nonparasitic cysts.
腹腔镜开窗术是有症状肝囊肿的首选治疗方法。尽管微创手术有诸多益处,但关于腹腔镜开窗术后症状复发和生活质量方面的长期预后数据有限。本研究的目的是评估该手术后患者报告的长期预后和满意度。
从一个前瞻性维护的数据库中识别出2001年至2012年期间在单一中心接受腹腔镜肝囊肿开窗术的所有患者。通过结构化电话访谈对包括症状缓解和生活质量在内的患者报告长期预后进行前瞻性评估。
共有98例患者接受了腹腔镜肝囊肿开窗术。中位随访时间为62个月(范围22至173个月)。48例患者有随访数据。4例患者出现影像学证实的复发证据,其中3例接受了进一步手术。该系列未报告死亡病例。发生了4例并发症,术后中位住院时间为2天(范围1至7天)。39例患者症状立即缓解,98%的患者报告长期满意。
腹腔镜肝囊肿开窗术并发症发生率低,能长期缓解症状。在处理非寄生虫性囊肿患者时,应将其视为首选治疗方式。