首页|腹腔镜下背腹侧结合路径解剖性肝S7段切除术治疗肝细胞癌的临床分析

腹腔镜下背腹侧结合路径解剖性肝S7段切除术治疗肝细胞癌的临床分析

Clinical analysis of laparoscopic anatomical hepatectomy of segment Ⅶ for hepatocellular carcinoma with dorsal-ventral combined approach

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目的 探讨腹腔镜下背腹侧结合路径解剖性肝S7段切除术在治疗肝细胞癌中的临床应用价值.方法 回顾性分析2020年12月至2023年4月在江南大学附属医院肝胆外科接受腹腔镜下背腹侧结合路径解剖性肝S7段切除术的23例肝细胞癌患者的临床资料,其中男性11例,女性12例,年龄(58.5±7.9)岁.总结分析患者的手术情况、术后并发症和随访情况.结果 23例患者手术均顺利完成,无中转开腹者.手术时间为(286.7±63.4)min,术中出血量200(150,400)ml,均未输血.术后无腹腔出血、胆漏、肝功能衰竭、腹腔感染等严重并发症发生,2例患者术后右侧胸腔积液,行穿刺引流后治愈.患者术后第2天均可下床活动,术后住院时间为(9.36±1.72)d.病灶长径为(4.38±1.42)cm.患者术后 3 个月复查甲胎蛋白为(3.26±0.93)ng/ml,与术前(46.75±9.43)ng/ml相比差异有统计学意义(t=38.24,P=0.008).术后随访过程中检查甲胎蛋白均正常,MRI检查未发现肿瘤复发转移.结论 腹腔镜下背腹侧结合路径解剖性肝S7段切除术治疗肝细胞癌具有临床实用性,值得推广.
Objective To study the feasibility of laparoscopic anatomical hepatectomy of segmentⅦ for hepatocellular carcinoma(HCC)with dorsal-ventral combined approach.Methods Clinical data of 23 patients with HCC undergoing laparoscopic anatomical hepatectomy of segment Ⅶ with dorsal-ventral combined approach in Jiangnan University Affiliated Hospital from December 2020 to April 2023 were retro-spectively collected,including 11 males and 12 females,aged(58.5±7.9)years old.The patient's perio-perative data,postoperative complications,and follow-ups were analyzed.Results All patients underwent the surgery successfully without conversion to laparotomy.The operation time was(286.7±63.4)min,the amount of intraoperative blood loss[M(Q1,Q3)]was 200(150,400)ml without blood transfusion.There were no major complications such as abdominal bleeding,bile leakage,liver failure or abdominal infection.Two cases had right pleural effusion and were managed with thoracic drainage.The patients could ambulate on postoperative day 2,and the postoperative hospital stay was(9.36±1.72)d.The diameter of the lesion was(4.38±1.42)cm.The serum level of alpha fetoprotein(AFP)three months after surgery was(3.26± 0.93)ng/ml,lower than the preoperative baseline(46.75±9.43)ng/ml(t=38.24,P=0.008).All patients showed normal serum levels of AFP and there were no tumor recurrence or metastasis during postoperative follow-ups.Conclusion Laparoscopic anatomical hepatectomy of segment Ⅶ for HCC with dorsal-ventral combined approach is feasible and worth spreading.

LaparoscopesSegmental hepatectomySegment 7 of liverAnatomical hepatec-tomyHepatocellular carcinoma

陈武强、何友钊、胡浩、金成、陈恩洪

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江南大学附属医院肝胆外科,无锡 214000

腹腔镜 肝段切除 肝S7段 解剖性肝切除 肝细胞癌

2024

中华肝胆外科杂志
中华医学会

中华肝胆外科杂志

CSTPCD北大核心
影响因子:1.846
ISSN:1007-8118
年,卷(期):2024.30(2)
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