新辅助联合机器人右半肝切除治疗进展期肝癌:Laennec入路联合背侧入路  

Conversion therapy combined with robot assisted laparoscopic hepatectomy in patients with advanced hepatocellular carcinoma:laennec approach with dorsal approach

作　　者：曹亚娟 张来柱 余德才 Cao Yajuan;Zhang Laizhu;Yu Decai(Hepatobiliary and Pancreatic Center&Liver Transplantation Center,The Affiliated Drum Tower Hospital,School of Medicine,Nanjing University,Nanjing 210008,China)

机构地区：[1]南京鼓楼医院肝胆胰外科,210008

出　　处：《中华腔镜外科杂志（电子版）》2022年第2期115-116,共2页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：肝细胞癌患者(CNLC2019Ⅱa期)接受术前新辅助治疗(mFOLFOX6肝动脉灌注化学药物治疗联合络氨酸激酶抑制药)4个周期后行手术治疗。采用机器人辅助手术系统,二氧化碳人工气腹,上腹部扇形布局5孔,连接机器人手术系统,Laennec入路肝周游离,切除胆囊,游离肝右动脉并离断,Laennec入路循下腔静脉游离腔静脉旁部直至第二肝门,劈开尾状叶腔静脉旁部,Laennec入路解剖离断右肝蒂,沿腔静脉背侧入路分离肝实质,Laennec入路显露肝中静脉,并循肝中静脉腹侧离断肝实质直至第二肝门,Endo GI离断肝右静脉根部,原位切除右肝。创面止血,上腹正中切口,取物袋取出标本。Patients with hepatocellular carcinoma(stage CNLC2019Ⅱa)underwent conversion therapy(mFOLFOX6 hepatic arterial perfusion chemotherapy combined with tyrosine kinase inhibitor)and received right hemihepatectomy after 4 cycles.Using robot-assisted surgical system,five holes and artificial pneumoperitoneum with CO2 was established.After the ligamentum teres and falciform ligament were dissected,the gallbladder was removed.Free right hepatic artery and right liver pedicle with laennec approach,then disconnected them.From the inferior vena cava to the second hilum,the liver parenchyma was splitted along the right side of the ischemic line and ICV.The root of right hepatic vein was cut with linear Endo GI,then the right half liver was excised in situ.The median operating hole was extended to remove the specimen.

关 键 词：肝细胞癌 转化化学药物治疗 肝动脉灌注化学药物治疗 机器人辅助腹腔镜肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]