CAJ | 학술논문

目的探讨腹腔镜肝切除术治疗肝脏肿瘤的可行性及临床应用价值.方法回顾性分析我院2010年5月至2013年10月期间由同一术者实施的40例腹腔镜肝切除术患者的临床资料,其中原发性肝细胞性肝癌27例,直肠癌肝转移2例,肝脏囊腺瘤2例,肝囊肿1例,肝脏血管瘤5例,肝局灶性结节性增生3例,病灶直径3.0～ 10.0 cm,平均(4±4) cm.结果所有患者均顺利完成手术,无中转开腹及围手术期死亡病例.其中不规则肝切除术21例,肝左外叶切除术12例,左半肝切除术3例,肝Ⅵ段切除术4例.手术时间为75 ～265 min,平均(166±109) min,术中出血80～750ml,平均(480±233) ml.其中2例肝细胞性肝癌患者术后病理切缘为阳性.术后1例患者出现胆漏,1例患者出现腹水,均予以保守治疗后康复,术后平均住院(7±14)d.结论在充分掌握适应证和手术技巧的情况下,腹腔镜肝切除术治疗肝脏肿瘤安全可行.
목적 탐토복강경간절제술치료간장종류적가행성급림상응용개치.방법 회고성분석아원2010년5월지2013년10월기간유동일술자실시적40례복강경간절제술환자적림상자료,기중원발성간세포성간암27례,직장암간전이2례,간장낭선류2례,간낭종1례,간장혈관류5례,간국조성결절성증생3례,병조직경3.0～ 10.0 cm,평균(4±4) cm.결과 소유환자균순리완성수술,무중전개복급위수술기사망병례.기중불규칙간절제술21례,간좌외협절제술12례,좌반간절제술3례,간Ⅵ단절제술4례.수술시간위75 ～265 min,평균(166±109) min,술중출혈80～750ml,평균(480±233) ml.기중2례간세포성간암환자술후병리절연위양성.술후1례환자출현담루,1례환자출현복수,균여이보수치료후강복,술후평균주원(7±14)d.결론 재충분장악괄응증화수술기교적정황하,복강경간절제술치료간장종류안전가행.
Objective To evaluate the feasibihty and clinical value of laparoscopic hepatectomy for liver tumors.Methods Laparoscopic hepatectomy from May 2010 to Oct 2013 was summarized including 27 cases of primary hepatocellular carcinoma,5 cases of liver hemangioma,3 cases of hepatic nodular hyperplasia,2 cases of liver metastases of colorectal cancer,2 cases of liver cystadenoma and 1 case of liver cyst.The diameter averaged at (4 ± 4) cm.Results All patients were successfully operated,no perioperative death.Irregular hepatectomy was performed in 21cases,hepatic left lateral lobectomy in 12 cases,segment VI resection in 4 cases and left hepatectomy in 3 cases.Operative time averaged (166 ± 109) min.Average blood loss was (480 ± 233) ml.Tumor margin was positive in two HCC cases.Bile leakage and ascites developed in one each patient,who were then cured by conservative treatment.Conclusions Laparoscopic hepatectomy for liver tumors is safe and feasible.