3D腹腔镜肝Ⅶ段病灶前切除术22例疗效分析

Clinical effects of 22 cases of 3D laparoscopic anterior resection in treatment of lesion located in liver VII segment

摘要:

目的 探讨3D腹腔镜肝Ⅶ段病灶前切除术的临床疗效及经验。方法 回顾性分析2016年1月－2019年12月22例在金华市中心医院行3D腹腔镜下肝Ⅶ段病灶前切除术患者的临床资料，其中原发性肝癌11例，结肠癌肝转移1例，血管瘤8例，血管平滑肌脂肪瘤1例，肝细胞局灶性结节性增生1例。统计分析所有患者的手术时间、术中出血量、术后并发症、术后拔引流管时间和术后住院总时间。结果 22例患者均成功完成手术。手术时间（253.3±93.5）min，术中出血量（240.0±92.3）mL，术后（1.0±0.5）d下床活动，术后平均（4.5±1.5）d拔除腹腔引流管，术后平均住院时间（8.0±1.0）d。术后有1例发生肺部感染和肺不张，无胆漏和腹腔出血等并发症发生。恶性肿瘤患者术后随访1年，无肿瘤复发。结论 采用3D腹腔镜病灶前切除术能良好的暴露肝脏Ⅶ段，是安全、可行的方法，值得临床推广应用。

Abstract:

Objective To explore the clinical effect and experience of 3D laparoscopic anterior resection of liver Ⅶ segment tumor.Methods Clinical data of 22 patients underwent 3D laparoscopic anterior hepatectomy for liver Ⅶ segment lesions from January 2016 to December 2019 was retrospectively analyzed. Among them, there were 11 cases of primary liver cancer, 1 case of liver metastasis from colon cancer, 8 cases of hemangioma, 1 case of vascular smooth muscle lipoma, and 1 case of focal nodular hyperplasia of hepatocytes. The operation time, bleeding volume during operation, postoperative complications, postoperative drainage tube removal time and hospital stay were observed and counted.Results All of the 22 patients completed the operation successfully. The average operation time was (253.3 ± 93.5) min, the bleeding volume during operation was (240.0 ± 92.3) mL, the average postoperative getting out of bed was (1.0 ± 0.5) d, the abdominal drainage tube was removed on an average of (4.5 ± 1.5) d after surgery, and the average hospital stay after surgery was (8.0 ± 1.0) d. Postoperative pulmonary infection and atelectasis occurred in 1 patient, and no other complications such as biliary leakage and abdominal hemorrhage occurred. The patients were followed up for 1 year without recurrence of malignant tumor after surgery.Conclusion Using 3D laparoscopic anterior lesion resection can good exposure Ⅶ liver segment, it is safe and feasible, and worthy of clinical promotion and application.