摘要
目的探讨冷切割技术在经脐单孔腹腔镜肝脏切除术中应用的可行性、安全性及临床意义。方法回顾性分析2013年至2017年中国医科大学附属盛京医院采用冷切割技术完成的35例单孔腹腔镜肝切除术临床资料。对患者的一般资料、围手术期数据进行统计分析。结果35例患者中男11例，女24例，年龄（49．9±10．8）岁，体重（63．2±11．1）kg。其中，肝血管瘤18例，肝内胆管结石5例，肝脏恶性肿瘤5例，肝局灶结节样增生3例，其他4例。35例均行手术治疗，包括肝左外叶切除22例，左半肝切除术2例，左肝部分切除术8例，右肝部分切除3例。手术均顺利完成，无中转多孔腹腔镜手术或开腹手术。患者手术时间（112．2±51．0）min，术中出血量（105．4±70．1）ml，手术费用（36336．7±5938．2）元。患者术后均恢复顺利，无术后出血、胆漏、切口感染等并发症发生。术后腹腔引流拔除时间及术后住院时间分别为（4．5±1．2）d和（5．2±1．4）d。所有患者术后均获随访，随访时间I～3个月。患者术后均无明显上腹部腹胀或腹痛不适等临床症状。结论冷切割技术在经脐单孔腹腔镜肝脏手术中应用是安全可行的，具有切割时间短、术中出血少、患者恢复快等优点。
Objective To study the application of the cold cutting technique in transumbilieal sin- gle-ineision laparoscopic liver resection （TUSI-LLR） , and to evaluate its feasibility and treatment results. Methods The clinical data of 35 patients with liver lesions treated by transumbilical single-incision laparoseopic liver resection from 2013 to 2017 were retrospectively analyzed in Shengjing Hospital of China Medical University. In all these patients, the liver parenchyma was transected with the cold cutting technique. The operation time, intraoperative blood loss, postoperative complications, time to remove abdominal drain, and total hospital stay in the patients were analyzed. Results 11 of the 35 patients were male. The average age was （49.9 ± 10.8） years. The average body weight was （63.2 ± 11.1 ） kg. The diagnoses were hemangiomas in 18 patients, hepatolithiasis in 5 patients, malignant hepatocellular tumors in 5 patients, focal nodular hyperplasia in 3 patients, and others in 4 patients. There were 22 left lateral sectioneetomies, 2 left hemi- hepatectomies, 11 wedge resections （8 in the left and 3 in the right）. The operations were all successfully performed, with no conversion to conventional laparoscopic hepatectomy or open surgery. The average operation time was （ 112.2 ± 51.0） minutes, and the intraoperative blood loss was （ 105.4 ± 70.1 ） ml. No patients required intraoperative blood transfusion. The average surgery cost was （ 36 336.7± 5 938.2 ） yuan. All patients recovered well, with no postoperative hemorrhage, bile leakage, or incisional wound infection. The average time periods for removal of the abdominal drain, and hospital stay were （4.5 ± 1.2） days and （ 5.2± 1.4） days, respectively. All the 35 patients were followed up （ 1 ± 3 months）, with no patients com- plaining of abdominal distension or abdominal pain. Conclusions The cold cutting technique in transumbilical single-incision laparoscopie liver resection was safe and feasible. Its benefits inclu
作者
姚殿波
吴硕东
于宏
柯昌伟
孙余田
郭峰
Yao Dianbo;Wu Shuodong;Yu Hong;Ke Changwei;Sun Yutian;Guo Feng(Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2018年第4期217-220,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
冷切割技术
肝切除术
腹腔镜
单孔
切割闭合器
Cold cutting technique
Liver resection, laparoseopic, single incision
Stapling devices
