CAJ | 학술논문

目的探讨手助腹腔镜技术在大肝癌切除中的应用价值.方法 2004年3月至2007年12月,在腹腔镜下肝内小病灶切除的基础上共对56例病变位于肝外周部位(Ⅱ～Ⅵ段)的直径大于5 cm大肝癌患者成功施行了手助腹腔镜肝切除术.其中肝细胞癌53例,肝内胆管细胞癌2例,肝转移性鳞癌1例.采用手助腹腔镜技术行规则性左肝叶切除或不规则性右肝切除术.结果 56例手助腹腔镜肝切除均获得成功,肝左外叶切除27例、左半肝切除6例,肝V、Ⅵ段不规则性切除23例.31例行肝门阻断,平均阻断时间为16.7 min,平均手术时间为105.3 min,平均出血量97 ml,瘤体平均大小8.6 cm,切除的肝组织最大径平均10.5 cm,术后无严重并发症发生,术后平均进食时间为2.1 d,术后平均住院7.3 d.结论在严格掌握患者手术指征的前提下,手助腹腔镜大肝癌切除是安全可行的.
목적 탐토수조복강경기술재대간암절제중적응용개치.방법 2004년3월지2007년12월,재복강경하간내소병조절제적기출상공대56례병변위우간외주부위(Ⅱ～Ⅵ단)적직경대우5 cm대간암환자성공시행료수조복강경간절제술.기중간세포암53례,간내담관세포암2례,간전이성린암1례.채용수조복강경기술행규칙성좌간협절제혹불규칙성우간절제술.결과 56례수조복강경간절제균획득성공,간좌외협절제27례、좌반간절제6례,간V、Ⅵ단불규칙성절제23례.31례행간문조단,평균조단시간위16.7 min,평균수술시간위105.3 min,평균출혈량97 ml,류체평균대소8.6 cm,절제적간조직최대경평균10.5 cm,술후무엄중병발증발생,술후평균진식시간위2.1 d,술후평균주원7.3 d.결론 재엄격장악환자수술지정적전제하,수조복강경대간암절제시안전가행적.
Objective To investigate the practical value of hand-assisted laparoscopic hepatectomy for large liver cancer in peripheral segments.Methods From March 2004 to December 2007,56 patients with large liver cancer underwent hand-assisted laparoscopic hepatectomy including 53 cages of hepatocellular carcinoma,2 cases of cholangiocelluar carcinoma,1 case of hepatic metastatic squamous carcinoma.Results The operation procedures were completed safely in all patients including 27 left lateral segmentectomies,6 left hemihepatectomies and 23 atypical right hepatectomy.Thirty-one cases with hepatic hilum blocking in the procedure and the mean time Wag 16.7 minutes.Mean surgical time wag 105.3 minutes.Mean blood loss Wag 97 ml Mean gross tumor size was 8.6 cm. Mean excisional hepatic tissue volume was 10.5 cm.No serious postoperative complications occurred.Mean eating time was 2.1 days.The mean postoperative hospital stay was 7.3 days.Conclusion Hand-assisted laparoscopic hepatectomy for large liver carcinoma is feasible and safe for selected patients.