CAJ | 학술논문

目的探讨腹腔镜解剖性左半肝切除术在治疗肝脏肿瘤中的价值.方法回顾性分析2006年3月至2012年1月21例因肝脏肿瘤而行腹腔镜解剖性左半肝切除术患者的临床资料.观察指标包括手术时间、术中失血量、术后并发症等.断肝方式为超声刀+ LigaSure联合分离法,结合腔镜下切割缝合器.结果术后病理证实原发性肝癌13例,肝血管瘤8例.平均手术耗时335(220～425) min,术中出血量约650(180 ～1 220) ml.4例术后发生胆漏,经充分引流1～4周治愈.术后平均住院时间为8.2(5 ～12)d.肝脏恶性肿瘤患者术后随访31(13 ～72)个月,肿瘤复发5例,其中4例因肿瘤复发转移死亡.结论腹腔镜下解剖性左半肝切除术是一种安全、有效、微创的手术.其不但适用于良性肿瘤,也适用于恶性肿瘤,能达到根治要求.
목적 탐토복강경해부성좌반간절제술재치료간장종류중적개치.방법 회고성분석2006년3월지2012년1월21례인간장종류이행복강경해부성좌반간절제술환자적림상자료.관찰지표포괄수술시간、술중실혈량、술후병발증등.단간방식위초성도+ LigaSure연합분리법,결합강경하절할봉합기.결과 술후병리증실원발성간암13례,간혈관류8례.평균수술모시335(220～425) min,술중출혈량약650(180 ～1 220) ml.4례술후발생담루,경충분인류1～4주치유.술후평균주원시간위8.2(5 ～12)d.간장악성종류환자술후수방31(13 ～72)개월,종류복발5례,기중4례인종류복발전이사망.결론 복강경하해부성좌반간절제술시일충안전、유효、미창적수술.기불단괄용우량성종류,야괄용우악성종류,능체도근치요구.
Objective To explore the technique and clinical application of laparoscopic anatomical left hemihepatectomy in the treatment of liver tumors.Methods From March 2006 to January 2012,21 patients underwent lapamscopic anatomical left hemihepatectomy.Data including operating time,blood loss and postoperative complications were collected and analyzed retrospectively.The liver parenchyma was transected using a laparoscopic ultrasonic scalpel and ligasure,together with an endoscopic linear stapler.Results Laparoscopic anatomical left hemihepatectomy was carried out in patients with primary liver carcinoma (n =13) and hemangioma (n =8).The mean blood loss was 650 (180 ～ 1 220) ml,the mean surgical time was 335 (220 ～425) minutes,and the mean postoperative hospital day was 8.2 (5 ～ 12) days.Postoperative complications included four patients with bile leakage,which recovered after 1 ～ 4 weeks of treatment with draining.Patients with malignant tumors were followed-up at a median of 31 (13 ～ 72)months.Tumor recurrence happened in five patients and four had died of recurrence and metastasis.Conclusions Laparoscopic anatomical left hemihepatectomy is a safe,feasible and efficacious procedure for the treatment of benign and malignant liver diseases in properly selected patients.It is recommended to treat patients with hepatocellular carcinoma.