Kara Salih, Korkut Ercan, Aksungur Nurhak, Altundaş Necip, Öztürk Gürkan, Ağırman Enes, Yıldız Metin
Department of Transplantation Center, Atatürk University Faculty of Medicine, Erzurum, Turkey.
Department of General Surgery, Erzurum City Hospital, Erzurum, Turkey.
Eurasian J Med. 2023 Oct;55(3):234-238. doi: 10.5152/eurasianjmed.2023.23119.
With the developments in patient management and the increase in surgical experience, the use of laparoscopy in liver resections has become widespread. However, with the consensus meetings and international recommendations, laparoscopic liver resections have been tried to be standardized. We aimed to present this laparoscopic liver resection experience by comparing open and laparoscopic techniques.
Patients who underwent liver resections between 2015 and 2022 were retrospectively screened and divided into 2 groups as laparoscopic liver resections and patients who underwent liver resection with open surgery. Indications, resection techniques, operative times, length of hospital stay, early hospital mortality, and complications were compared between both groups using statistical methods.
Laparoscopic surgery was performed in 31 (14%) patients, and open surgery was performed in 189 (86%). The mean operation time was 316 ± 168.2 minutes in patients who underwent laparoscopic liver resection. It was 329.4 ± 123.6 in the open surgery group. The length of hospital stay was 11.6 ± 4.9 days in patients who underwent laparoscopic liver resection, while it was 19.7 ± 12.1 days in patients who underwent open surgery. The difference between the length of hospital stay was statistically significant (Mann-Whitney U-test, P=.00). There was no difference between the 2 groups in terms of complications and early mortality.
Laparoscopic liver resections are a safe method that can be applied in 3 or less segment resections. As the experience of the surgical team increases, it can be safely applied for major hepatectomies.
随着患者管理的发展和手术经验的增加,腹腔镜技术在肝切除术中的应用已变得广泛。然而,通过共识会议和国际建议,人们一直在努力使腹腔镜肝切除术标准化。我们旨在通过比较开放手术和腹腔镜手术技术来介绍这种腹腔镜肝切除术的经验。
对2015年至2022年间接受肝切除术的患者进行回顾性筛选,并分为腹腔镜肝切除术组和接受开放手术的肝切除术患者组。使用统计方法比较两组之间的适应症、切除技术、手术时间、住院时间、早期医院死亡率和并发症。
31例(14%)患者接受了腹腔镜手术,189例(86%)患者接受了开放手术。接受腹腔镜肝切除术的患者平均手术时间为316±168.2分钟。开放手术组为329.4±123.6分钟。接受腹腔镜肝切除术的患者住院时间为11.6±4.9天,而接受开放手术的患者住院时间为19.7±12.1天。住院时间的差异具有统计学意义(曼-惠特尼U检验,P = 0.00)。两组在并发症和早期死亡率方面无差异。
腹腔镜肝切除术是一种安全的方法,可应用于3个及以下肝段的切除。随着手术团队经验的增加,它也可安全地应用于大型肝切除术。