摘要
目的:探讨三维重建技术联合超声乳化吸引(cavitron ultrasonic surgical aspirator,CUSA)刀施行肝切除术的临床疗效.方法:收集2009-01/2012-12在广州医科大学附属第二医院肝胆外科接受手术治疗的53例临床资料,所有病例均经病理学确诊为原发性肝细胞肝癌.A组27例,为术前进行肝脏肿瘤的三维重建,术中应用CUSA刀施行肝切除术;B组26例,为常规开腹肝切除术,比较两组的治疗效果.结果:在入肝血流(第一肝门)阻断时间(7.4min±5.6 min vs 18.3 min±7.6 min,P<0.05)、术中失血量(出血量>1 L者,18.5%vs 46.1%,P<0.05)和术中输血方面(术中有输血者,22.2%vs 50.0%,P<0.05),A组显著低于于B组.此外,两组总生存率比较无统计学意义(χ2=1.165,P>0.05);而A组无瘤生存率为48.1%,B组为30.8%,经Log-rank检验,A组的无瘤生存率显著高于B组(χ2=7.122,P<0.05).结论:三维重建技术联合CUSA刀行肝切除术具有相当高地临床疗效,值得临床应用和推广.
AIM： To assess the clinical efficacy of threedimensional reconstructive technique combined with cavitron ultrasonic surgical aspirator（CUSA） to perform hepatectomy. METHODS： Fifty-three patients with pathologically confirmed hepatocellular carcinoma（HCC） who underwent hepatectomy from January 2009 to December 2012 at our hospital were divided into two groups： A and B. In group A（n = 27）, hepatectomy was performed using preoperative three-dimensional reconstructive technique and CUSA during operation, while group B（n = 26） received traditional hepatectomy. Their clinical efficiency and safety were compared between the two groups. RESULTS： The tolerance limit of hepatic inflow occlusion（the first porta hepatis）（7.4 min ± 5.6 min vs 18.3 min ± 7.6 min, P 0.05）, operative blood loss（1 L, 18.5% vs 46.1%, P 0.05） and blood transfusion（22.2% vs 50.0%, P 0.05） in group A were significantly less than those in group B（P 0.05）. Moreover, cumulative survival rate showed no significant difference between the two groups（χ2 = 1.165, P 0.05）. Tumor-free survival rate in group A（48.1%） was significantly higher than that in group B（30.8%）（χ2 = 7.122, P 0.05）. CONCLUSION： Hepatectomy performed using three-dimensional reconstructive technique plus CUSA is safe and effective.
出处
《世界华人消化杂志》
CAS
北大核心
2014年第25期3843-3848,共6页
World Chinese Journal of Digestology
基金
广州市科技划项目-珠江科技新星专项基金资助项目
No.2012J2200039~~
关键词
三维重建技术
超声乳化吸引刀
肝细胞癌
肝切除
Three-dimensional reconstructive tech-nique Cavitron ultrasonic surgical aspirator Hepa-tocellular carcinoma Hepatectomy
