构建三角模型规划腹腔镜肝中叶上段肿瘤局部切除术路径的应用价值  

Application value of triangular modal construed for planning approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe

作　　者：范宁[1] 郭源[1] 吴力群[1] 柳国芳[1] 牛庆慧[1] 刘超[1] 辛洋[1] 代增强 赵延荣 王岩[1] 李聪[1] 臧运金[1] 蔡金贞 Fan Ning;Guo Yuan;Wu Liqun;Liu Guofang;Niu Qinghui;Liu Chao;Xin Yang;Dai Zengqiang;Zhao Yanrong;Wang Yan;Li Cong;Zang Yunjin;Cai Jinzhen(Department of Liver Diseases,the Affiliated Hospital of Qingdao University,Qingdao 266103,Shandong Province,China)

机构地区：[1]青岛大学附属医院肝病中心,266103

出　　处：《中华消化外科杂志》2021年第8期906-912,共7页Chinese Journal of Digestive Surgery

基　　金：国家科技重大专项(2018ZX10302205-005)。

摘　　要：目的探讨构建三角模型规划腹腔镜肝中叶上段肿瘤局部切除术路径的应用价值。方法采用回顾性描述性研究方法。收集2020年1~6月青岛大学附属医院收治的10例行腹腔镜肝中叶上段肿瘤局部切除术病人的临床病理资料;男6例,女4例;中位年龄为54岁,年龄范围为41~63岁。所有病人术前构建三角模型规划腹腔镜肝中叶上段肿瘤局部切除术路径。观察指标:(1)病人术前一般情况。(2)手术情况。(3)随访情况。采用门诊或电话方式进行随访,了解病人肿瘤复发情况和生存情况。随访时间截至2021年2月。正态分布的计量资料以x±s表示。偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示。结果(1)病人术前一般情况:10例病人中,肝细胞癌7例、胆管细胞癌2例、卵巢癌肝转移1例;肿瘤位于肝S4a段3例,肝S8腹侧段2例,肝S8背侧段2例,跨肝S4a+S8段腹侧段3例。肿瘤长径为(3.4±1.0)cm。(2)手术情况:10例病人顺利完成手术,均为R0切除,无术中输血和中转开腹病人。10例病人手术时间为(149±59)min、术中出血量为(294±163)mL、标本最小切缘为(1.1±0.2)cm。术后第1天丙氨酸氨基转移酶为(324±151)U/L、术后第1天天冬氨酸氨基转移酶为(401±113)U/L、术后住院时间为(9±4)d。10例病人均未发生胆汁漏、出血等并发症,无再次手术。(3)随访情况:10例病人获得术后随访,中位随访时间为11个月,随访时间范围为7~13个月。所有病人无切缘复发和远处转移。结论构建三角模型规划腹腔镜肝中叶上段肿瘤局部切除术路径安全、可行。Objective To investigate the application value of triangular modal construed for planning approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe.Methods The retrospective and descriptive study was conducted.The clinicopathological data of 10 patients who underwent local laparoscopic resection of liver tumors located in superior part of central liver lobe at the Affiliated Hospital of Qingdao University from January to June 2020 were collected.There were 6 males and 4 females,aged from 41 to 63 years,with a median age of 54 years.Preoperative triangular model was constructed for all patients to plan approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe.Observation indicators:(1)preoperative general situations of patients;(2)surgical situations;(3)follow-up.Follow-up was conducted by outpatient examination or telephone interview to detect tumor recurrence and survival of patients up to February 2021.Measurement data with normal distribution were expressed as Mean±SD.Count data were expressed was absolute numbers.Results(1)Preoperative general situations of patients:hepatocellular carcinoma was found in 7 cases,inthahepatic cholangiocarcinoma was found in 2 cases and ovarian cancer with liver metastasis was found in 1 case.Three cases had tumors located in S4a segment,2 cases had tumors located in ventral subsegment of S8 segment,2 cases had tumors located in dorsal subsegment of S8 segment,and 3 cases had tumors across the ventral segment of S4a+S8.The diameter of tumors was(3.4±1.0)cm.(2)Surgical situation:all the 10 patients underwent R0 resection successfully,with no intraoperative blood transfusion or conversion to open surgery.The operation time of 10 patients was(149±59)minutes,the volume of intraoperative blood loss was(294±163)mL,the minimum surgical margin of specimen was(1.1±0.2)cm.The alanine aminotransferase was(324±151)U/L on the postoperative first day,the aspartic aminotransferase was(401±113)U/L

关 键 词：肝肿瘤 肝中叶 肝切除术 三角模型 手术路径 腹腔镜检查 

分 类 号：R735.7[医药卫生—肿瘤]