CAJ | 학술논문

目的研究应用Habib 4X双极射频设备辅助腹腔镜切肝的应用价值.方法对2009年9月至2012年4月我院31例腹腔镜Habib 4X射频辅助肝切除病例的手术和临床效果进行分析.结果 30例完成腹腔镜下手术,1例中转开腹.其中左肝外叶切除12例,左半肝切除1例,第Ⅴ或第Ⅵ肝段切除9例,Ⅴ、Ⅵ肝段联合切除2例,肝楔形切除6例.联合胆囊切除2例.切肝时间10～68 min,中位切肝时间24 min；出血量8～370ml,平均(145±75)ml.术后肝功能指标轻度异常,经护肝治疗3～5 d恢复正常.术后平均住院时间7.8±2.6(3～12)d.无术后出血、胆漏及感染并发症.结论对于Ⅱ、Ⅲ、Ⅳa、Ⅴ、Ⅵ肝段病灶的腹腔镜肝切除,应用Habib 4X射频凝固断肝技术,无需肝门解剖和血流阻断,可提高切肝速度,减少术中出血,降低术后肝功能异常程度,降低肝癌病灶切缘局部复发的风险,值得临床推广应用.
목적 연구응용Habib 4X쌍겁사빈설비보조복강경절간적응용개치.방법 대2009년9월지2012년4월아원31례복강경Habib 4X사빈보조간절제병례적수술화림상효과진행분석.결과 30례완성복강경하수술,1례중전개복.기중좌간외협절제12례,좌반간절제1례,제Ⅴ혹제Ⅵ간단절제9례,Ⅴ、Ⅵ간단연합절제2례,간설형절제6례.연합담낭절제2례.절간시간10～68 min,중위절간시간24 min；출혈량8～370ml,평균(145±75)ml.술후간공능지표경도이상,경호간치료3～5 d회복정상.술후평균주원시간7.8±2.6(3～12)d.무술후출혈、담루급감염병발증.결론 대우Ⅱ、Ⅲ、Ⅳa、Ⅴ、Ⅵ간단병조적복강경간절제,응용Habib 4X사빈응고단간기술,무수간문해부화혈류조단,가제고절간속도,감소술중출혈,강저술후간공능이상정도,강저간암병조절연국부복발적풍험,치득림상추엄응용.
Objective To evaluate the efficacy of laparoscopic Habib 4X (Habib 4X,Angio Dynamics US),a new bipolar radiofrequency (RF) device,in laparoscopic liver resection.Methods Thirty one patients who underwent laparoscopic liver resection using the laparoscopic Habib 4X from Sept 2009 to Apr 2012 were studied retrospectively.Results The laparoscopic Habib 4X was success fully used in 30 patients (malignant,n=18; benign,n=12).The procedures performed included left lateral sectionectomy (n=12),left hemi-hepatectomy (n=1),Ⅴ or Ⅵ segmentectomy (n=9),Ⅴ and Ⅵ bi-segmentectomy (n=2) and wedge exclusion (n=6).The time required for precoagulation and resection was 10～68 min (median 24 min).The mean intraoperative blood loss was 145±75ml (range 8-370 ml).Mild abnormal liver function which returned to normal in 3 to 5 days was detected postoperatively.The mean hospital stay was 7.8±2.6 d (range 3～12 days).There was no patient who developed postoperative bleeding,bile leakage or abdominal abscess.For cancer patients,there was no local recurrence on follow-up.Conclusion Laparoscopic Habib 4X,a device when used in laparoscopic liver resection,resulted in minimal blood loss and quick recovery.It had only mild effect on liver function and it had low morbidity.In addition,it might reduce the risk of local recurrence in malignant tumours.