应用三维重建及虚拟肝切除系统的腹腔镜下精准切除右肝肿瘤  

Three.dimensional reconstruction and virtual hepatectomy for laparoscopic precise liver resection of right liver tumor

作　　者：邵贤[1] 贾乃昕[2] 陈佳慧[3] 陈钟[1] 

机构地区：[1]南通大学附属医院肝胆外科,江苏省226001 [2]昆山市第一人民医院 [3]复旦大学附属中山医院心内科

出　　处：《中华普通外科杂志》2016年第7期538-540,共3页Chinese Journal of General Surgery

基　　金：江苏省科技厅临床医学科技专项基金资助项目（BL2014060）;江苏省科教兴卫工程医学领军人才和创新团队基金资助项目（LJ201134）;南通大学研究生科技创新计划基金资助项目（YKS14018）

摘　　要：目的评价三维重建及虚拟肝切除系统用于有肝肿瘤腹腔镜精准肝切除的临床价值。方法回顾性分析2012年6月至2015年10月南通大学附属医院收治的右肝肿瘤腹腔镜肝切除患者31例的临床资料。患者分为2组，三维重建组15例，对照组16例。观察手术时间、术中出血量、术后并发症和术后住院时间。结果三维重建组均成功行完全腹腔镜下有肝肿瘤切除．对照组1例手辅助完成肝切除，1例中转开腹，其余14例行完全腹腔镜下右肝肿瘤切除。2组患者手术时间[三维重建组（141±36）min，对照组（207±66）min]、术中出血量[三维重建组（274±88）ml，对照组（418±189）m1]、术后住院时间[三维重建组（9±3）d，对照组（13±6）d]，差异有统计学意义，2组术后均无明显并发症发生。结论术前三维重建及虚拟肝切除系统应用有助于腹腔镜肝切除术中肝右叶实质内肿瘤定位，可明确肿瘤切除面与瘤周脉管关系，通过对脉管预处理缩短手术时间，减少术中出血及副损伤，有利于术后快速康复，达到精准肝切除的要求。Objective To evaluate the clinical value of three-dimensional reconstruction and virtual hepatectomy for laparoscopic precise liver resection of right liver tumor. Methods 31 cases of right liver tumor from June 2012 to October 2015 at Department of HepatobiliaPy Surgery in Affiliated Hospital of Nantong University, were analyzed retrospectively. Patients were divided into three dimensional reconstruction group （n = 15） and control group （n = 16）, Operation time, bleeding volume during operation, postoperative complications and days of hospitalization after operation in two groups were obsewed. Results All operation was successfully performed with pure laparoscopic right liver tumor resection in three dimensional reconstruction group. In control group, l case was completed by hand-assisted laparoscopic liver resection, 1 case was converted to open operation, the remaining 14 cases underwent total laparoscopic right liver tumor resection. Operation time in 3-dimensional reconstruction group was （ 141 ± 36） rain vs. （207 ± 66） rain in control group, bleeding volume was （274 ± 88 ）ml vs. （418 ± 189 ）ml, hospitalization after operation was （9 ± 3） days vs. （ 13 ＋ 6） days （all P 〈 0. 05）. Conclusions Preoperative three-dimensional reconstruction and virtual hepatectomy can ensure the localization of parenchyma tumor during the laparoscopic precise liver resection, clarifing the relationship between tumor operation section and peritumoral vascular or biliary ducts, fulfilling the idea of precise liver resection.

关 键 词：肝肿瘤 肝切除术 腹腔镜 成像 三维 

分 类 号：R735.7[医药卫生—肿瘤]