摘要
目的探讨3D腹腔镜在肝切除术的临床应用价值。方法收集2013年10月至2015年8月46例肝脏肿瘤腹腔镜肝切除术患者的临床资料,包括3D腹腔镜组22例和2D腹腔镜组24例,分析比较两组肝切除术方式、手术时间、术中出血量、术后住院时间、术后并发症等指标。结果 3D腹腔镜组与2D腹腔组肝切除术手术方式大部分肝切除术27.3%(6例)和25%(6例),小部分肝切除术68.2%(15例)和70.8%(17例),手术方式比较差异性无统计学意义。3D腹腔镜组肝切除术手术时间短于2D腹腔镜组(150±62 min vs 205±94 min,P=0.024),差异有统计学意义(P<0.05)。3D腹腔镜组与2D腹腔镜组术中出血量(267±233 ml vs 289±265 ml,P=0.774),术后住院时间(7.8±2.7 d vs 8.2±3.2 d,P=0.936),并发症发生情况(18.2%vs 25%,P=0.575),差异比较均无统计学意义。结论与2D腹腔镜比较,3D腹腔镜下清晰的三维立体视觉,解剖层次更清晰可辨,有助于肝切除术精细操作,缩短手术时间。
Objective To explore the application value of three-dimensional （3D）laparoscopic visualization during liver resection. Methods From October 2013 to August2015, 46 patients with liver tumors underwent laparoscopic hepatectomy in our department. Among these cases, 22 patients underwent laparoscopic hepatectomy （LH） by 3D laparoscope, and 24 patients underwent LH by two-dimensional （2D） laparoscope. The surgical methods of LH, the operation time and the intraoperative blood loss, postoperative hospital stay and operative complications were collected and analytic comparation was performed. Results The number of patients who underwent major hepatectomy was 6 （27.3%） in the 3D group and 6 （25%）in the 2D group, and minor hepatectomy was 15 （68.2%） in 3D group and 17 （70.8%） in 2D group. There was no significant difference between them, respectively. The operative time was significantly shorter in the 3D group when compared to 2D group （1504- 62 min vs 205-4-94 rain, P=0.024）. No differences were found in intraoperative blood loss （267±233 ml in 3D group vs 289±265 ml in 2D, P=0.774）, postoperative hospital stay （7.8±2.7 d vs 8.2±3.2 d, P=0.936）, and operative complications （ 18.2% vs 25%, P=0.575） respectively. Conclusion When compared to 2D laparoscope, 3D laparoscope that provides 3D stereoscopic visualizationcan facilitate to identify anatomical structures clearly, and be helpful to complex operations, and then may reduce the operating time.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2016年第1期96-99,103,共5页
Chinese Journal of Clinical Anatomy
基金
南宁市普通外科腔镜微创中心建设项目(20153012)
