CAJ | 학술논문

目的探讨完全腹腔镜肝切除治疗肝脏肿瘤的安伞性及有效性.方法不阻断肝脏血流的情况下,联合采用超声刀、Ligasure及血管夹进行完伞腹腔镜下肝切除15例,其中肝海绵状血管瘤9例,直径5.0～15.0 cm(平均直径7.9 cm),肝囊肿纤维化3例,其中2例为引流术后复发,均位于左外叶,左外叶明显缩小.原发件肝癌3例,直径1.0～5.0 cm,肝功能均为Child A级.结果 15例患者腹腔镜肝切除均获成功,其中左外叶切除6例,其余患者为肝不规则切除,无中转手术.平均手术时间110 min,术中出血虽30～500 ml,平均251 ml.术后平均住院时间6.5 d,无术后死亡,术后除1例患者肝癌创面渗血,保守治愈外,其余无并发症,全部治愈.结论对位于Ⅱ、Ⅲ、Ⅳa、Ⅴ、Ⅵ段肝脏肿瘤患者,采用完全腹腔镜肝切除是一种安全有效的微创治疗方法.
목적 탐토완전복강경간절제치료간장종류적안산성급유효성.방법 불조단간장혈류적정황하,연합채용초성도、Ligasure급혈관협진행완산복강경하간절제15례,기중간해면상혈관류9례,직경5.0～15.0 cm(평균직경7.9 cm),간낭종섬유화3례,기중2례위인류술후복발,균위우좌외협,좌외협명현축소.원발건간암3례,직경1.0～5.0 cm,간공능균위Child A급.결과 15례환자복강경간절제균획성공,기중좌외협절제6례,기여환자위간불규칙절제,무중전수술.평균수술시간110 min,술중출혈수30～500 ml,평균251 ml.술후평균주원시간6.5 d,무술후사망,술후제1례환자간암창면삼혈,보수치유외,기여무병발증,전부치유.결론 대위우Ⅱ、Ⅲ、Ⅳa、Ⅴ、Ⅵ단간장종류환자,채용완전복강경간절제시일충안전유효적미창치료방법.
Objective To evaluate the safety and feasibility of total laparoscopic hepatectomy for liver neoplasms.Methods Laparoscopic hepatectomy in 15 patients with liver neoplasms were completed by combined application of ultrasound scalpel,Ligasure and vascular clip without blockage of liver blood flow,including 9 cases of hepatic cavernous hemangioma,whose diameters were from 5.0 cm to 15.0 cm,3 cases of hepatic cyst with fibrosis,located in left lateral hepatic lobe,3 cases of primary hepatic carcinoma,whose diameters were from 1.0 cm to 5.0 cm and the hepatic functions were all Child A.Results Laparoscopic hepatectomy was completed successfully in all 15 cases with no conversion to open laparotomy,including 6 cases of left lateral hepatectomy,9 cases of irregular hepatectomy.The mean operative time was 110 min,blood loss during operation was from 30 ml to 500 ml,the average was 251 ml.The mean postoperative hospital stay was 6.5 d.The mortality rate was 0%.No severe complications occurred except 1 case of small amount bleeding which stopped itself.Conclusion Total laparoscopic hepatectomy is a feasible,safe and minimal invasive approach for patients with liver neoplasms within segment Ⅱ、Ⅲ、Ⅳa、Ⅴ、 and Ⅵ.