Kong Xiaohan, Niu Zheyu, Wang Heng, Liu Meng, Ma Chaoqun, Lu Jun, Zhou Xu, Zhu Huaqiang
Department of Hepatobiliary Surgery, Shandong Provincial Hospital, Shandong First Medical University, 324 Jingwuweiqi Road, Jinan, 250021, China.
Department of Clinical Research, Qilu Synva Pharmaceutical Co. Ltd, Dezhou, China.
Langenbecks Arch Surg. 2025 Jan 4;410(1):25. doi: 10.1007/s00423-024-03595-3.
To compare outcomes of LLR in VI/VII of the liver in Left-lateral Decubitus Jackknife Position (LDJP) and traditional Supine Position (SP). We used propensity score matching (PSM) to analyze clinical outcomes.
PATIENTS & METHODS: This study retrospectively analyzed patients undergoing LLR for liver tumors in segments VI and/or VII at Shandong Provincial Hospital from 2018 to 2023. A total of 218 cases were included (LDJP, n = 94; SP, n = 124). Matched 1:1 PSM groups were created and clinical indicators compared between groups.
218 LLR patients, 94 LDJP and 124 supine. After 1:1 PSM, each group had 62 patients. No significant differences in clinical or laboratory parameters. All surgeries were successful, 1 LDJP conversion to open resection and 4 SP conversions (P = 0.375). LDJP average surgery duration: 220.6 ± 29.9 min, supine position: 262.6 ± 35.6 min (P < 0.001). LDJP perioperative blood loss: 169.0 ± 74.4 mL, supine position: 231.6 ± 84.6 mL (P < 0.001). Four LDJP patients required intraoperative blood transfusion compared to 16 supine position patients (P = 0.012). All cases had negative margins postoperatively. No significant differences in postoperative complications (8 LDJP vs 9 supine, P = 0.675) or length of hospital stay (25 LDJP vs 26 supine, ≥ 7 days) (P = 1.000).
Laparoscopic partial hepatectomy in LDJP for hepatic VI/VII tumor safe and feasible. Reduces operative time, blood loss, transfusion requirement, improving outcomes.
比较左侧卧位折刀位（LDJP）与传统仰卧位（SP）下肝Ⅵ/Ⅶ段腹腔镜肝切除术（LLR）的手术效果。我们采用倾向评分匹配法（PSM）分析临床结局。
本研究回顾性分析了2018年至2023年在山东省立医院接受肝Ⅵ和/或Ⅶ段肝肿瘤LLR的患者。共纳入218例患者（LDJP组，n = 94；SP组，n = 124）。创建1:1匹配的PSM组，并比较两组之间的临床指标。
218例LLR患者，94例采用LDJP，124例采用仰卧位。1:1 PSM后，每组各有62例患者。临床或实验室参数无显著差异。所有手术均成功，1例LDJP转为开腹切除，4例SP转为开腹切除（P = 0.375）。LDJP平均手术时间：220.6±29.9分钟，仰卧位：262.6±35.6分钟（P < 0.001）。LDJP围手术期失血量：169.0±74.4毫升，仰卧位：231.6±84.6毫升（P < 0.001）。4例LDJP患者术中需要输血，而仰卧位患者有16例（P = 0.012）。所有病例术后切缘均为阴性。术后并发症（LDJP组8例 vs SP组9例，P = 0.675）或住院时间（LDJP组25例 vs SP组26例，≥7天）（P = 1.000）无显著差异。
LDJP下肝Ⅵ/Ⅶ段肿瘤的腹腔镜肝部分切除术安全可行。可减少手术时间、失血量和输血需求，改善手术效果。
