中华肝脏外科手术学电子杂志Issue(3)：152-156,5.DOI:10.3877/cma.j.issn.2095-3232.2014.03.006
3D腹腔镜下解剖性肝切除术治疗肝脏肿瘤的应用价值
Value of 3D laparoscopic anatomical hepatectomy for liver tumors
摘要
Abstract
Objective To investigate the value of three dimensional (3D) laparoscopic anatomical hepatectomy for liver tumors. Methods Clinical data of 10 patients with liver tumors who underwent 3D laparoscopic anatomical hepatectomy in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from September to November 2013 were analyzed retrospectively. There were 7 males and 3 females with age ranging from 36 to 62 years old and the median age of 49 years old. The primary disease were primary liver cancer (n=8), hepatic hemangioma(n=2). The informed consents of all patients were obstained and the ethical committee approval was received. All the patients underwent 3D laparoscopic anatomical hepatectomy through endotracheal general anesthesia. The operators and assistants wore special 3D glasses. After the 3D laparoscope was inserted through the navel incision, operation channels were established by putting 3 to 4 trocars (5 mm or 10 mm) at different positions of upper abdomen respectively, and then anatomical hepatectomy was performed according to the diseased region. The operaton procedures, intraoperative blood loss, length of hospital stay and postoperative complications of patients were observed. Results All the 10 patients underwent anatomical hepatectomy through 3D laparoscope, and no case converted to open surgery during the operation. Three cases received right hemihepatectomy, 3 cases received segment Ⅴ+Ⅵ hepatectomy, 2 cases received hepatic left lateral lobectomy, 1 case received mesohepatectomy, and 1 case received segment Ⅴ hepatectomy. The average operation duration of patients who underwent right hemihepatectomy was (270±26)min, segment Ⅴ+Ⅵ hepatectomy was (122±8)min, hepatic left lateral lobectomy was (90±7)min, mesohepatectomy was 245 min, and segment Ⅴ hepatectomy was 95 min. The intraoperative blood loss was (483±104), (233±29), (125±35), 450, 180 ml, and the length of hospital stay was (17±5), (11±1), (9±1), 13, 10 d accordingly. Liver disfunction was observed in 1 case out of the patients after right hemihepatectomy. Right lower lung infection was observed in the patient after mesohepatectomy. No complication was observed in the other 8 patients after operations. Conclusions The 3D laparoscope has a certain advantage in dissecting the intrahepatic ductal structures precisely, and can help to control the intraoperative blood loss. It is applicable to anatomical hepatectomy for liver tumors, especially to hemihepatectomy.关键词
腹腔镜/成像,三维/肝肿瘤/肝切除术Key words
Laparoscopes/Imaging, three-dimensional/Liver neoplasms/Hepatectomy引用本文复制引用
张红卫,李闻达,曹君,商昌珍,张磊,陈亚进..3D腹腔镜下解剖性肝切除术治疗肝脏肿瘤的应用价值[J].中华肝脏外科手术学电子杂志,2014,(3):152-156,5.基金项目
中山大学临床医学研究5010计划项目 （）
