Glisson蒂横断式精准肝切除术在小儿肝脏肿瘤手术中的应用研究  

Precision liver resection with Glissonian pedicle transection for surgical treatment of hepatic tumors in children

作　　者：王博 席红卫[1] 徐峥 崔强强[1] 张鹏[1] Wang Bo;Xi Hongwei;Xu Zheng;Cui Qiangqiang;Zhang Peng(Department of General Surgery,Shanxi Children′s Hospital,Taiyuan 030013,China)

机构地区：[1]山西省儿童医院普外科,太原030013

出　　处：《中国药物与临床》2022年第6期516-519,共4页Chinese Remedies & Clinics

基　　金：山西省科技厅课题(201903D321159)。

摘　　要：目的探讨Glisson蒂横断式精准肝切除术在小儿肝脏肿瘤手术中的应用体会。方法收集山西省儿童医院普外科2019年5月至2021年3月收治7例肝脏肿瘤患儿,其中男性5例,女性2例,年龄16 d至7岁,中位年龄17个月,7例患儿肿瘤长径5.5~21.5 cm,中位长径10.4 cm,瘤体位于肝右叶3例,肝左叶4例,术前检查提示肝母细胞瘤4例,肝脏间叶错构瘤1例,肝脏血管瘤2例。结果7例患儿均采用Glisson蒂横断法顺利完成相应的肝段或者肝叶的切除,其中1例完成右半肝切除,1例完成右后区(S6、S7)切除,1例完成右三肝(S4、5、6、7、8)切除,3例完成左半肝切除,1例完成左三肝(S2、3、4、5、8)切除。手术时间130~292 min,术中出血量为30~120 ml,3例患儿术中渗血较多,输浓缩红细胞120~200 ml。术后随访时间为4~24个月,无肝功能衰竭、严重感染、低蛋白血症等严重并发症,无肿瘤复发病例。结论Glisson蒂横断式精准肝切除术在小儿肝脏肿瘤切除术中是安全可行的,在小儿精准肝切除手术中操作简单、安全。Objective To investigate the use of precision liver resection with Glissonian pedicle transec-tion for surgical treatment of hepatic tumors in children.Methods Seven children with hepatic tumors treated in our department between May 2019 and March 2021 were included,comprising 5 boys and 2 girls aged 16 days to 7 years with a median age of 17 months.In the 7 patients,the tumor was 5.5 to 21.5cm by diameter with a medi-an of 10.4cm,located in the right(n=3)or the left lobe(n=4)of the liver.Preoperative investigation identified hep-atoblastoma in 4 patients,mesenchymal hamartoma in 1,and hemangioma in 2.Results Glissonian pedicle tran-section method was used successfully in resection of the related liver segments or lobes in all 7 children.Of them,right hemihepatectomy was performed in 1 patient,resection of the right posterior regions(S6,S7)in 1,right trilobectomy in 1(S4,5,6,7,8),left hemihepatectomy in 3,and left trilobectomy in 1(S2,3,4,5,8).The opera-tion time was 130 to 292 min,and the intraoperative blood loss was 30 to 120ml.Transfusion of concentrated red blood cells(120~200 ml)was needed in 3 patients who experienced considerable amount of blood oozing at surgery.The postoperative follow-up lasted for 4 to 24 months.There was no serious complications such as liver failure,severe infection,and hypoalbuminemia.None of the patients had tumor recurrence.Conclusion Glisso-nian pedicle transection for precision liver resection is safe and feasible in surgical treatment for hepatic tumors in children.The operation is simple and safe for this purpose.

关 键 词：Glisson蒂 肝切除术 儿童 肝肿瘤 

分 类 号：R735.7[医药卫生—肿瘤]