Chen Shengxiong, Jin Xiaoxu, Hao Zijia, Wang Yijun, Du Chengxu, Liu Xiaoding, Jiang Huiqing
Department of Hepatobiliary Surgery, The Second Hospital of Hebei Medical University Shijiazhuang 050000, Hebei, PR China.
Department of Gastroenterology, The Second Hospital of Hebei Medical University Shijiazhuang 050000, Hebei, PR China.
Am J Transl Res. 2025 May 15;17(5):3862-3874. doi: 10.62347/FEMB3665. eCollection 2025.
To evaluate the efficacy of a novel self-designed liver suspension device in three-dimensional (3D) laparoscopic non-anatomical (NAR) resection for tumors in hepatic segments VI and VII.
Clinical records of 79 patients undergoing NAR resection of hepatic segments VI and VII at the Second Hospital of Hebei Medical University (June 2016-December 2021) were retrospectively reviewed. Patients were stratified into the Suspension Device Laparoscopic Group (SDLG), utilizing the self-designed suspension device for 3D-guided resection, and the Conventional Laparoscopic Group (CLG). Statistical analyses comprised two-sample t-tests, chi-square tests, and Log-rank tests. Perioperative outcomes including surgical time, hepatic pedicle occlusion time, intraoperative blood loss, postoperative hospital stay, drainage tube removal time, time to ambulation, postoperative flatus recovery, and complications (pleural effusion, ascites, bile leakage, wound infection/liquefaction/effusion) were compared. Postoperative hepatic functional recovery (Child-Pugh classification) and 1-/3-year survival rates were assessed.
The SDLG demonstrated significantly shorter surgical time, reduced intraoperative blood loss, and abbreviated hepatic pedicle clamping time compared to the CLG. Postoperative hepatic functional recovery, as assessed by Child-Pugh classification, was accelerated in the SDLG cohort, with a higher proportion achieving baseline function earlier than the CLG. Complication rates, including pleural effusion, ascites, and bile leakage, were markedly lower in the SDLG, while no significant differences were observed in hospitalization duration, ambulation initiation, or flatus recovery. Survival analysis revealed the 1-/3-year survival rate of SDLG was higher than that of CLG.
The self-designed liver suspension device enhances the safety and efficiency of 3D laparoscopic NAR resection for hepatic segment VI and VII tumors by minimizing operative trauma, reducing mechanical injury risks, and promoting postoperative hepatic functional recovery. Its application is associated with fewer procedure-related complications to conventional techniques, and increased survival rate. These advantages underscore its potential as a valuable innovation in minimally invasive liver surgery, meriting further clinical validation and integration with complementary technologies to refine surgical precision and outcomes.
评估一种新型自行设计的肝脏悬吊装置在三维（3D）腹腔镜下对肝Ⅵ、Ⅶ段肿瘤进行非解剖性（NAR）切除术中的疗效。
回顾性分析河北医科大学第二医院2016年6月至2021年12月期间79例行肝Ⅵ、Ⅶ段NAR切除术患者的临床资料。将患者分为悬吊装置腹腔镜组（SDLG），采用自行设计的悬吊装置进行3D引导下切除，以及传统腹腔镜组（CLG）。统计分析包括两样本t检验、卡方检验和对数秩检验。比较围手术期结果，包括手术时间、肝蒂阻断时间、术中出血量、术后住院时间、引流管拔除时间、下床活动时间、术后胃肠排气恢复时间及并发症（胸腔积液、腹水、胆漏、伤口感染/液化/积液）。评估术后肝功能恢复情况（Child-Pugh分级）及1/3年生存率。
与CLG相比，SDLG的手术时间明显缩短，术中出血量减少，肝蒂阻断时间缩短。根据Child-Pugh分级评估，SDLG组术后肝功能恢复加快，达到基线功能的比例高于CLG组。SDLG组的并发症发生率，包括胸腔积液、腹水和胆漏，明显较低，而在住院时间、开始下床活动或胃肠排气恢复方面未观察到显著差异。生存分析显示，SDLG组的1/3年生存率高于CLG组。
自行设计的肝脏悬吊装置通过最大限度地减少手术创伤、降低机械损伤风险并促进术后肝功能恢复，提高了3D腹腔镜下对肝Ⅵ、Ⅶ段肿瘤进行NAR切除的安全性和效率。与传统技术相比，其应用相关的手术并发症更少，生存率更高。这些优势凸显了其作为微创肝脏手术中有价值创新的潜力，值得进一步的临床验证并与辅助技术相结合，以提高手术精度和改善手术效果。
