双窥视孔完全腹腔镜下Ⅶ段肝肿瘤切除术55例疗效分析*

Clinical effects of double peephole approach totally laparoscopic hepatectomy in treatment of tumor located in liver VII segment (55 cases)*

摘要:

探讨双窥视孔完全腹腔镜下Ⅶ段肝肿瘤切除术的安全性及临床疗效。方法 回顾性分析2012年9月－2016年6月接受双窥视孔完全腹腔镜下Ⅶ段肝肿瘤切除术的55例患者的临床资料。观察统计患者的手术时间、出血量、术后下床时间、术后拔除引流管时间、住院时间、并发症及随访结果。结果 该组中52例腹腔镜下完成手术，3例中转开腹手术，手术时间（160.0±45.0）min，出血量（320.0±80.0）ml，术后（1.0±0.0）d下床活动，术后平均（5.0±1.5）d拔除腹腔引流管、术后住院时间（7.0±1.5）d，无术后腹腔内出血、胆瘘、肝功能衰竭和腹腔感染等并发症发生。术后随访1年无肿瘤复发。结论 采用双窥视孔能够对Ⅶ段肝脏有良好的暴露，腹腔镜下Ⅶ段肿瘤切除术是安全、可行、微创、并发症少的治疗方法，值得临床推广。

Abstract:

To explore the safety and clinical effects of double peephole approach totally laparoscopic hepatectomy in treatment of tumor located in liver VII segment. Methods 55 patients received double peephole approach totally laparoscopic hepatectomy. The clinical data on operative time, intraoperative bleeding, postoperative time to get out of bed, postoperative time of removal of drainage-tube, complication and duration of hospital stay were collected and analyzed retrospectively.?Result?52 operations were carried out successfully with laparoscopic surgery. 3 operations were carried out in open surgery. The mean operative time was (160.0 ± 45.0) min. The average intraoperative blood loss was (320.0 ± 80.0) ml. The mean postoperative time to get out of bed was (1.0 ± 0.0) d. And the mean time of remove drainage-tube was (5.0 ± 1.5) d. All the patients recovered smoothly without any biliary fistula, intraabdominal hemorrhage, liver failure and postoperative abdominal infection. The average hospital stay was (7.0 ± 1.5) d. No tumor recurred in 1 year follow-up. Conclusions Double peephole approach totally laparoscopic hepatectomy was an efficacious, safe, and minimally invasive procedure in treatment of tumor located in liver VII segment.