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比较腹腔镜肝切除术治疗第 8 段腹侧和背侧区域。

Comparison of laparoscopic liver resection for the ventral versus the dorsal areas of segment 8.

机构信息

Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.

出版信息

Langenbecks Arch Surg. 2024 Aug 7;409(1):243. doi: 10.1007/s00423-024-03435-4.

Abstract

PURPOSE

The technical difficulties of laparoscopic liver resection (LLR) are greatly associated with the location of liver tumors. Since segment 8 (S8) contains a wide area, the difficulty of LLR for S8 tumors may vary depending on the location within the segment, such as the ventral (S8v) and dorsal (S8d) area, but the difference is unclear.

METHODS

We retrospectively investigated 30 patients who underwent primary laparoscopic partial liver resection for liver tumors in S8 at Kobe University Hospital between January 2018 and June 2023.

RESULTS

Thirteen and 17 patients underwent LLR for S8v and S8d, respectively. The operation time was significantly longer (S8v 203[135-259] vs. S8d 261[186-415] min, P = 0.002) and the amount of blood loss was significantly higher (10[10-150] vs. 10[10-200] mL, P = 0.034) in the S8d group than in the S8v group. No significant differences were observed in postoperative complications or postoperative length of hospital stay. Additionally, intraoperative findings revealed that the rate at which the case performed partial liver mobilization in the S8d group was higher (2[15.4%] vs. 8[47.1%], P = 0.060) and the median parenchymal transection time of the S8d group was longer (102[27-148] vs. 129[37-175] min, P = 0.097) than those in the S8v group, but there were no significant differences.

CONCLUSION

The safety of LLR for the S8d was comparable to that of LLR for S8v, although LLR for S8d resulted in longer operative time and more blood loss.

THE TRIAL REGISTRATION NUMBER

B230165 (approved at December 26, 2023).

摘要

目的

腹腔镜肝切除术(LLR)的技术难度与肝肿瘤的位置密切相关。由于第 8 段(S8)包含一个广泛的区域,因此 S8 肿瘤的 LLR 难度可能因段内位置而异,例如腹侧(S8v)和背侧(S8d)区域,但差异尚不清楚。

方法

我们回顾性调查了 2018 年 1 月至 2023 年 6 月期间在神户大学医院接受 S8 原发性腹腔镜部分肝切除术的 30 例肝肿瘤患者。

结果

13 例和 17 例患者分别行 S8v 和 S8d 的 LLR。S8d 组的手术时间明显更长(203[135-259] vs. 261[186-415] min,P = 0.002),出血量明显更多(10[10-150] vs. 10[10-200] mL,P = 0.034)。S8d 组的术后并发症或术后住院时间无显著差异。此外,术中发现 S8d 组部分肝移动的病例比例较高(2[15.4%] vs. 8[47.1%],P = 0.060),S8d 组肝实质切开时间中位数较长(102[27-148] vs. 129[37-175] min,P = 0.097),但无显著差异。

结论

S8d 的 LLR 安全性与 S8v 的 LLR 相当,尽管 S8d 的 LLR 导致手术时间延长和出血量增加。

试验注册号

B230165(2023 年 12 月 26 日批准)。

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