腹腔镜肝癌切除术中应用射频凝血器断肝的价值  

Application value of radiofrequency coagulation device for hepatic transection in laparoscopic hepatectomy

作　　者：金浩[1] 刘会春[1] 王勇[1] 宋培军[1] 李宗狂[1] 鲁贻民[1] 周磊[1] 

机构地区：[1]蚌埠医学院第一附属医院肝胆外科,安徽蚌埠233004

出　　处：《中国普通外科杂志》2016年第1期45-50,共6页China Journal of General Surgery

摘　　要：目的:评价腹腔镜肝癌切除术中应用射频凝血器断肝的临床效果。方法:回顾性分析2011年7月—2015年12月行完全腹腔镜肝癌切除手术45例患者的临床资料,根据断肝器械不同将患者分为观察组(20例,射频凝血器断肝)和对照组(25例,超声刀断肝),比较两组相关临床指标。结果:观察组与对照组比较,手术时间无统计学差异(P>0.05);术中出血量[(325.00±111.80)m L vs.(628.00±119.09)m L)]、输血患者比例(3/20vs.11/25)、术后24 h腹腔引流量[(110.00±57.95)m L vs.(334.40±209.56)m L]均明显降低(均P<0.05);术后肝功能指标、住院时间、并发症发生率及住院费用均无统计学差异(均P>0.05);术后总生存率(75.0%vs.72.0%)差异无统计学意义(P>0.05),但无瘤生存率(75.0%vs.36.0%)明显升高(P<0.05)。结论:在腹腔镜肝癌手术中,应用射频凝血器断肝可有效减少出血,减少术后并发症,提高无瘤生存率,近期效果优于术中使用超声刀者。Objective： To evaluate the clinical efficacy of using radiofrequency coagulation device for hepatic parenchymal transection in laparoscopic hepatectomy for liver cancer. Methods： The clinical data of 45 patients undergoing laparoscopic hepatectomy for liver cancer from July 2011 to December 2015 were retrospective analyzed. According to the hepatic parenchymal transection device used, the patients were divided into observational group （20 cases） using radiofrequency coagulation device for hepatic parenchymal transection and control group （25 cases） using ultrasonic scalpel for hepatic parenchymal transection. The relevant clinical variables between the two groups were compared. Results： In observational group compared with control group, the operative time showed no significant difference （P〉0.05）, the intraoperative blood loss [（325.00±111.80） mL vs. （628.00±119.09） mL], the proportion receiving blood transfusion （3/20 vs. 11/25） and the postoperative 24-h abdominal drainage volume [ （110.00±57.95） mL vs.（334.40±209.56） mL] were all significantly decreased （all P〈0.05）. The postoperative liver function parameters, length of hospital stay incidence of complications and total hospital costs showed no significant difference （all P〉0.05）. The overall survival rate （75.0% vs. 72.0%） showed no significant difference （P〉0.05）, but the tumorfree survival rate （75.0% vs. 36.0%） was significantly increased （P〈0.05）. Conclusion： In laparoscopic hepatectomy for liver cancer, using radiofrequency coagulation device for hepatic parenchymal transection can effectively control blood loss, reduce postoperative complications and improve tumor-free survival rate, and its short-term efficacy is superior to the intraoperative use of ultrasonic scalpel.

关 键 词：肝肿瘤/外科学 肝切除术/方法 腹腔镜 电凝术 

分 类 号：R735.7[医药卫生—肿瘤]