腹腔镜下肝楔形切除与解剖性切除的疗效对比研究  

The comparison of curative effect between wedge and anatomical resection in laparoscopic liver resection

作　　者：孟健[1] 杜松涛[1] 张劲光[1] 

机构地区：[1]首都医科大学普通外科中心,北京100069

出　　处：《腹腔镜外科杂志》2016年第5期321-324,共4页Journal of Laparoscopic Surgery

基　　金：北京市医院管理局重点医学专业发展计划资助(编号:ZYLX201311)

摘　　要：目的:对比腹腔镜下解剖性左外叶切除(left lateral segmental hepatectomy,LS)与楔形切除术(wedge resection,WR)的预后及切缘情况。方法:收集2009年6月至2012年6月手术治疗的121例腹腔镜下肝切除患者,其中58例行LS,63例行WR,对比两组患者术中情况、肿瘤切缘、复发率及生存期。结果:术前两组患者一般情况差异无统计学意义,两组中转开腹率、失血量、输血量、死亡率、术后住院时间差异无统计学意义。LS所切除安全边缘更宽,术后3年肝内复发率与3年生存率均优于WR。结论:与WR相比,LS能达到更大的切除距离,预后更好,是更为可靠的腹腔镜下肿瘤切除方式。Objective： The left lateral segmental hepatectomy（ LS） and wedge resection（ WR） are common treatments in the left hepatic lobe tumor,the aim of this study was to compare the curative effect and the cut edge between these two kinds of laparoscopic operative methods. Methods： The object of study was 121 patients who underwent laparoscopic liver resection from Jun. 2009 to Jun.2012. 58 patients underwent LS,63 patients underwent WR. The intraoperative situations,tumor cut edge,recurrence rate and survival period were compared between the two groups. Results： There were no obvious differences in the general conditions,rate of conversion to laparotomy,blood loss,amount of blood transfusion,mortality and postoperative hospital stay between two groups. Compared with WR,LS had a wider safe margin,lower postoperative intrahepatic recurrence and higher survival rate in 3 years. Conclusions： Compared with WR,LS has a wider margin and better prog nosis. LS is a more reliable method in the laparoscopic resection.

关 键 词：肝肿瘤 肝切除术 腹腔镜检查 疗效比较研究 

分 类 号：R735.7[医药卫生—肿瘤]