CAJ | 학술논문

目的：探讨腹腔镜下规则性肝切除与肝肿瘤剥除术手术方式的选择和疗效的差别。方法回顾分析笔者所在医院2009年1月－2014年1月期间完成腹腔镜肝血管瘤切除术43例患者的临床资料。结果手术方式包括腹腔镜下规则性肝切除术25例（左半肝切除4例、左外叶切除11例、肝段切除5例、右半肝切除3例、尾状叶切除术2例）和肝血管瘤剥除术18例。分析得出肝剥除术切肝时间比规则性肝切除手术时间及切肝时间短，术中出血量少，术后肝功恢复时间短，肿瘤组织残余机会少。结论腹腔镜下肝血管瘤治疗中，根据肿瘤的大小、与大血管的关系、位置不同采用恰当的手术方式，可以安全、有效、微创地治疗比较复杂的肝血管瘤，从而达到最佳疗效。
목적：탐토복강경하규칙성간절제여간종류박제술수술방식적선택화료효적차별。방법회고분석필자소재의원2009년1월－2014년1월기간완성복강경간혈관류절제술43례환자적림상자료。결과수술방식포괄복강경하규칙성간절제술25례（좌반간절제4례、좌외협절제11례、간단절제5례、우반간절제3례、미상협절제술2례）화간혈관류박제술18례。분석득출간박제술절간시간비규칙성간절제수술시간급절간시간단，술중출혈량소，술후간공회복시간단，종류조직잔여궤회소。결론복강경하간혈관류치료중，근거종류적대소、여대혈관적관계、위치불동채용흡당적수술방식，가이안전、유효、미창지치료비교복잡적간혈관류，종이체도최가료효。
Objective To investigate the selection of two surgical procedures for resection of hepatic hemangioma laparoscopically-regular partial hepatectomy and enucleation,and to compare the differences of clinical curative effect.Methods The clinical data of 43 patients with hepatic hemangioma,from Jan. 2009 to Jan.2014 in Shanxi Provincial People′s Hospital,were analyzed retrospectively.All of the 43 patients underwent laparoscopic resection.Results Among the 43 cases,regular partial hepatectomy and enucleation were operated in 25 cases (58.1%)and 18 cases (41.9%),respectively.The regular partial hepatectomy group including 4 cases of left liver resection,11 cases of hepatic left lateral lobectomy, 5 cases of hepatic segmentectomy,3 cases of right liver resection and 2 cases of hepatic caudate lobectomy. Through analysis,enucleation has the following advantages in comparison with regular partial hepatectomy:shorter operative time, shorter hepatic resection operating time, less intra-operative bleeding, faster postoperative recovery,less residual tumors rate.Conclusion According to the size of tumor,the relationship between the tumor and surrounding great vessels and the location of tumor,using proper surgical option,which is safe,effective and mini-invasive in the treatment of complicated hepatic hemangioma,is the key to achieve the optimal curative effect.