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一项评估微创肝脏手术与开放性肝切除术中失血情况的文献综述。

A Literature Review to Assess Blood Loss in Minimally Invasive Liver Surgery Versus in Open Liver Resection.

作者信息

Elmahi Eiad, Salama Yahya, Cadden Fergal

机构信息

General Surgery, Lincoln County Hospital, Lincoln, GBR.

Surgery, Kettering General Hospital, Kettering, GBR.

出版信息

Cureus. 2021 Jun 28;13(6):e16008. doi: 10.7759/cureus.16008. eCollection 2021 Jun.

Abstract

Aim and objectives The aim of the study was to assess the amount of blood loss in minimally invasive hepatectomy and open liver resection for both benign and neoplastic conditions. Introduction Minimally invasive surgery has progressively developed to a stage where once-novel and highly specialized surgical techniques are now common practice. Colorectal surgery is the key example that has shown minimally invasive surgery as highly beneficial. Successes in the colorectal laparoscopic approach have now been integrated into the speciality of hepatopancreaticobiiary (HPB) surgery. In this review, we will compare the amount of blood loss in minimally invasive liver resection with the more traditional approach of open liver resection. Methods A literature review was conducted which included the length of patient mobilization as a postoperative complication following laparoscopic and open liver resections. Medline, PubMed, and Cochrane were accessed to review previously published studies. Twelve studies were selected, and all of them were in English, ranged from the year 2000 to 2020. Results Eleven out of the 12 included studies indicated that minimally invasive liver resection is associated with reduced blood loss. Conclusion In comparing both minimally invasive liver resection and classic open surgery, minimally invasive liver resection was shown to have reduced blood loss; this was seen in both malignant and benign tumours. Therefore, laparoscopic liver resection could be favoured over the classical open approach to avoid excessive blood loss intra-operatively.

摘要

目的和目标 本研究的目的是评估在良性和肿瘤性疾病中,微创肝切除术和开放性肝切除术的失血量。引言 微创手术已逐步发展到一个阶段,曾经新颖且高度专业化的手术技术如今已成为常规操作。结直肠手术就是一个关键例子,它表明微创手术非常有益。结直肠腹腔镜手术方法的成功现已融入肝胰胆(HPB)外科领域。在本综述中,我们将比较微创肝切除术与更传统的开放性肝切除术的失血量。方法 进行了一项文献综述,其中包括患者在腹腔镜和开放性肝切除术后作为术后并发症的动员时间长度。检索了Medline、PubMed和Cochrane以回顾先前发表的研究。选择了12项研究,所有研究均为英文,时间跨度从2000年至2020年。结果 12项纳入研究中的11项表明,微创肝切除术与失血量减少相关。结论 在比较微创肝切除术和经典开放性手术时,微创肝切除术显示失血量减少;在恶性和良性肿瘤中均观察到这一点。因此,与经典开放性手术方法相比,腹腔镜肝切除术可能更受青睐,以避免术中失血过多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fec8/8319637/763f18060644/cureus-0013-00000016008-i01.jpg

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