Heinrich Stefan, Tripke Verena, Huber Tobias, Mittler Jens, Lang Hauke
Department of General, Visceral, and Transplantation Surgery, University Hospital of Mainz, Germany.
JSLS. 2017 Oct-Dec;21(4). doi: 10.4293/JSLS.2017.00061.
In addition to general advantages of laparoscopic over open surgery, such as better cosmesis and faster recovery, laparoscopic liver surgery offers specific advantages. Improved liver function and potentially earlier postoperative oncologic treatment are suggested by the literature as benefits of laparoscopic over open liver surgery. The purpose of this analysis was to analyze the outcomes of laparoscopic liver surgery in our department.
All laparoscopic liver resections (LLRs) performed from January 2011 through July 2016 were identified from the institutional database and matched 1:2 to open liver resections (OLRs). Data were analyzed regarding perioperative outcome, and significance was set at < .05.
Of 1525 liver resections, 120 patients were included in this analysis. Forty resections were performed laparoscopically. Patients in the LLR group more often had benign tumors. No patient died after LLR, but 2 required conversion to open surgery (5%) because of bleeding. Blood loss (200 vs 500 mL, < .001) was less and hospital stay (6 vs. 7 days, = .001) shorter after LLR. Iwate score, operating time, and the size of the resection margins did not differ between the groups. Iwate score correlated with operative time ( = .027).
Laparoscopic liver surgery was safe, and several advantages over open surgery were confirmed in our series.
除了腹腔镜手术相对于开放手术的一般优势，如更好的美容效果和更快的恢复外，腹腔镜肝脏手术还具有特定优势。文献表明，与开放肝脏手术相比，腹腔镜肝脏手术具有改善肝功能和可能更早进行术后肿瘤治疗的优势。本分析的目的是分析我院腹腔镜肝脏手术的结果。
从机构数据库中识别出2011年1月至2016年7月期间进行的所有腹腔镜肝脏切除术（LLR），并按1:2与开放肝脏切除术（OLR）进行匹配。分析围手术期结果数据，显著性设定为<0.05。
在1525例肝脏切除术中，120例患者纳入本分析。其中40例为腹腔镜手术。LLR组患者更多患有良性肿瘤。LLR术后无患者死亡，但2例因出血需要转为开放手术（5%）。LLR术后失血量较少（200 vs 500 mL，<0.001），住院时间较短（6 vs. 7天，=0.001）。两组间岩手评分、手术时间和切缘大小无差异。岩手评分与手术时间相关（=0.027）。
腹腔镜肝脏手术是安全的，本系列研究证实了其相对于开放手术的若干优势。
