Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
Langenbecks Arch Surg. 2020 Sep;405(6):737-744. doi: 10.1007/s00423-020-01928-6. Epub 2020 Jul 9.
Laparoscopic hepatectomy has been used widely in liver disease due to its advantages as a minimally invasive surgery. However, laparoscopic caudate lobe resection (LCLR) has been reported rarely. We aimed to investigate the safety and feasibility of LCLR by comparing it with open liver surgery.
A retrospective study was performed including all patients who underwent LCLR and open caudate lobe resection (OCLR) between January 2015 and August 2019. Twenty-two patients were involved in this study and divided into LCLR (n = 10) and OCLR (n = 12) groups based on preoperative imaging, tumor characteristics, and blood and liver function test. Patient demographic data and intraoperative and postoperative outcomes were compared between the two groups.
There were no significant inter-group differences between gender, age, preoperative liver function, American Society of Anesthesiologists (ASA) grade, and comorbidities (P > 0.05). The LCLR showed significantly less blood loss (50 vs. 300 ml, respectively; P = 0.004), shorter length of hospital stay (15 vs. 16 days, respectively; P = 0.034), and shorter operative time (216.50 vs. 372.78 min, respectively; P = 0.012) than OCLR, but hospital expenses (5.02 vs. 6.50 WanRMB, respectively; P = 0.208) showed no statistical difference between groups. There was no statistical difference in postoperative bile leakage (P = 0.54) and wound infection (P = 0.54) between LCLR and OCLR. Neither LCLR nor OCLR resulted in bleeding or liver failure after operation. There were no deaths.
LCLR is a very useful technology, and it is a feasible choice in selected patients with benign and malignant tumors in the caudate lobe.
腹腔镜肝切除术因其作为微创手术的优势，已广泛应用于肝脏疾病。然而，腹腔镜尾叶切除术（LCLR）的报道很少。我们旨在通过与开腹肝手术比较，研究 LCLR 的安全性和可行性。
对 2015 年 1 月至 2019 年 8 月期间行 LCLR 和开腹尾叶切除术（OCLR）的所有患者进行回顾性研究。该研究纳入 22 例患者，根据术前影像学、肿瘤特征、血液和肝功能检查将患者分为 LCLR 组（n=10）和 OCLR 组（n=12）。比较两组患者的人口统计学数据、术中及术后结果。
两组间在性别、年龄、术前肝功能、美国麻醉医师协会（ASA）分级和合并症方面无显著差异（P>0.05）。LCLR 组术中出血量（分别为 50ml 和 300ml；P=0.004）、住院时间（分别为 15 天和 16 天；P=0.034）和手术时间（分别为 216.50 分钟和 372.78 分钟；P=0.012）均明显少于 OCLR 组，但两组间住院费用（分别为 5.02 万元和 6.50 万元；P=0.208）无统计学差异。LCLR 和 OCLR 术后胆漏（P=0.54）和伤口感染（P=0.54）发生率无统计学差异。LCLR 和 OCLR 术后均未发生出血或肝功能衰竭。无死亡病例。
LCLR 是一项非常有用的技术，在选择有良性和恶性尾叶肿瘤的患者中是可行的选择。
