腹腔镜肝切除术治疗巨大肝肿瘤安全吗？来自单个机构的建议：采用前入路完全腹腔镜半肝切除术治疗直径大于 10 cm 的巨大肝肿瘤。
Is Laparoscopic Hepatectomy Safe for Giant Liver Tumors? Proposal from a Single Institution for Totally Laparoscopic Hemihepatectomy Using an Anterior Approach for Giant Liver Tumors Larger Than 10 cm in Diameter.
机构信息
Department of Surgery, Iwate Medical University School of Medicine, Morioka 028-3695, Japan.
出版信息
Curr Oncol. 2022 Oct 31;29(11):8261-8268. doi: 10.3390/curroncol29110652.
BACKGROUND
The efficacy and safety of laparoscopic liver resections for liver tumors that are larger than 10 cm remain unclear. We developed a safe laparoscopic right hemihepatectomy for giant liver tumors using an anterior approach.
METHODS
Eighty patients who underwent laparoscopic hemihepatectomy between January 2011 and December 2021 were divided into a nongiant tumor group ( = 65) and a giant tumor group ( = 15) for comparison.
RESULTS
The median operating time, amount of blood loss, and length of postoperative hospital stay did not differ significantly between the nongiant and giant tumor groups. The sizes of the tumors and weights of the resected liver were significantly larger in the giant tumor group. A comparison between a nongiant group ( = 23) and a giant group ( = 12) treated with laparoscopic right hemihepatectomy showed similar results.
CONCLUSIONS
Laparoscopic hemihepatectomy, especially that performed on the right side, for giant tumors larger than 10 cm can be performed safely. Surgical techniques for giant liver tumors have been standardized, and their application is expected to spread widely in the future.
背景
对于大于 10cm 的肝肿瘤，腹腔镜肝切除术的疗效和安全性仍不清楚。我们采用前入路开发了一种安全的腹腔镜右半肝切除术用于治疗巨大肝肿瘤。
方法
2011 年 1 月至 2021 年 12 月期间，80 例行腹腔镜肝切除术的患者被分为非巨大肿瘤组（n=65）和巨大肿瘤组（n=15）进行比较。
结果
非巨大肿瘤组和巨大肿瘤组的中位手术时间、出血量和术后住院时间无显著差异。巨大肿瘤组的肿瘤大小和切除肝脏的重量明显更大。腹腔镜右半肝切除术治疗的非巨大肿瘤组（n=23）和巨大肿瘤组（n=12）之间的比较结果相似。
结论
对于大于 10cm 的巨大肿瘤，腹腔镜半肝切除术，特别是右侧半肝切除术，可以安全进行。巨大肝肿瘤的手术技术已经标准化，预计未来将广泛应用。
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