定位针引导下腹腔镜精准局部肝切除应用探索  

The exploration of the application of laparoscopic precise local hepatectomy guided by the positioning needle

作　　者：陈政[1,2] 叶庆旺 赵东波 石鑫 吴建强 余德才 Zheng Chen;Qingwang Ye;Dongbo Zhao;Xin Shi;Jianqiang Wu(Department of Hepatobiliary Surgery,The Affiliated Suqian Hospital of Xuzhou Medical University,Jiangsu 210008,China;Department of Hepatobiliary Surgery,the Affiliated Drum Tower Hospital,Medical School of Nanjing University,Jiangsu 223800,China 2.Department of Hepatobiliary Surgery,the Affiliated Drum Tower Hospital,Medical School of Nanjing University,Jiangsu 223800,China)

机构地区：[1]南京大学医学院附属鼓楼医院普通外科肝胆与肝移植外科,江苏210008 [2]南京鼓楼医院集团宿迁医院、徐州医科大学附属宿迁医院肝胆外科,江苏223800

出　　处：《中华腔镜外科杂志（电子版）》2024年第2期125-128,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：宿迁市科技计划资助(K202116);江苏省第六期"333"青年人才项目。

摘　　要：目的探索定位针引导腹腔镜下深部肝肿瘤局部切除的安全性与可行性。方法回顾分析2021年6月至2022年12月6例经术前超声或CT定位深部肝肿瘤行腹腔镜下肝肿瘤局部切除患者的病历资料,评估穿刺针定位的安全性、荷瘤靶域切除的精准性和R0切除率。结果1例患者2个病灶行超声定位、5例患者行CT定位。6例患者7个病灶定位确切、锚定可靠,无松脱、移位,定位引起出血5~30(13.2±9.8)ml;切缘0.9~2.5(1.9±0.5)cm,R0切除率100%。结论定位针定位准确可靠、安全可行,能起到良好的定位、引导作用,是特定条件下术中超声和荧光腔镜的有益补充。Objective To Explore the safety and effective of laparoscopic liver resection guided by the positioning needle for deep hepatic tumors.Methods We retrospectively reviewed 6 patients with HCC who underwent laparoscopic hepatectomy(LH)guided by the positioning needle from Jun.2021 to Dec.2022.The safety of needle positioning and accuracy of target-territory resection together with R0 resection rate were analyzed.Results 1 patient with 2 lesions simultaneously were localized by ultrasound,while the remaining 5 cases were all CT guided localization.All lesions were accurately located and anchored reliably,without loosening or displacement.In 6 patients,All 7 lesions achieved R0 resection(100%).The hemorrhage caused by localization operation was 5 to 30(13.2±9.8)ml.The margin-negative was 0.9 to 2.5(1.9±0.5)cm.There were no perioperative mortality and reoperation cases.Conclusions The pilot study shows that positioning needle is effective and safe,helpful to precise positioning and localization guidance.Under specific conditions,it may be a beneficial supplement to intraoperative ultrasound and ICG fluorescence-guided LH surgery.

关 键 词：定位针 腹腔镜 肝切除术 肝细胞癌 肿瘤定位 影像学 

分 类 号：R657.3[医药卫生—外科学]