Shimada M, Matsumata T, Taketomi A, Shirabe K, Yamamoto K, Itasaka H, Sugimachi K
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Arch Surg. 1995 Feb;130(2):157-60. doi: 10.1001/archsurg.1995.01430020047007.
To clarify the efficacy of transdiaphragmatic hepatectomy.
Transdiaphragmatic hepatectomy and transabdominal hepatectomy were retrospectively compared.
This technique is used in cirrhotic patients with hepatocellular carcinoma located near the diaphragm.
Thirty-six cirrhotic patients with hepatocellular carcinoma who underwent transdiaphragmatic (group 1 [n = 8]) or transabdominal (group 2 [n = 28]) hepatectomies between April 1985 and March 1993 were investigated. All patients underwent a partial hepatectomy for hepatocellular carcinoma less than 3 cm in diameter located in segment VII or VIII or near the confluence of the hepatic veins.
Intraoperative and postoperative clinical parameters, including operative time, blood loss, and length of hospital stay.
The mean +/- SD operative time was significantly shorter in group 1 (184 +/- 25 minutes) than in group 2 (270 +/- 79 minutes). The intraoperative blood loss was significantly smaller in group 1 (857 +/- 622 mL) than in group 2 (1318 +/- 926 mL). The rate of postoperative complications was lower in group 1 (13% [n = 1]) than in group 2 (43% [n = 12]). The postoperative hospital stay was significantly shorter in group 1 (16 +/- 5 days) than in group 2 (23 +/- 16 days).
Transdiaphragmatic hepatectomy is a useful technique for cirrhotic patients with hepatocellular carcinoma located near the diaphragm.
阐明经膈肝切除术的疗效。
对经膈肝切除术和经腹肝切除术进行回顾性比较。
该技术用于患有位于膈肌附近的肝细胞癌的肝硬化患者。
对1985年4月至1993年3月期间接受经膈（第1组[n = 8]）或经腹（第2组[n = 28]）肝切除术的36例患有肝细胞癌的肝硬化患者进行了研究。所有患者均因位于VII或VIII段或肝静脉汇合处附近、直径小于3 cm的肝细胞癌接受了部分肝切除术。
术中及术后临床参数，包括手术时间、失血量和住院时间。
第1组的平均±标准差手术时间（184±25分钟）明显短于第2组（270±79分钟）。第1组的术中失血量（857±622 mL）明显少于第2组（1318±926 mL）。第1组的术后并发症发生率（13%[n = 1]）低于第2组（43%[n = 12]）。第1组的术后住院时间（16±5天）明显短于第2组（23±16天）。
经膈肝切除术对于患有位于膈肌附近的肝细胞癌的肝硬化患者是一种有用的技术。
