单中心51例单孔腹腔镜肝切除经验总结

目的:探讨单孔腹腔镜肝切除术的疗效及安全性,总结其手术经验。方法:回顾分析2009年12月至2015年8月完成的51例单孔腹腔镜肝切除术的临床资料,并对比良恶性疾病接受单孔腹腔镜肝切除术的疗效。全组共51例患者(男18例,女33例),良性疾病38例,恶性疾病13例,平均(43.51±11.83)岁。结果:51例单孔腹腔镜肝切除术均成功完成,无加孔或中转开腹。手术时间平均(112.65±53.23)min,其中良性疾病平均(97.11±25.33)min,恶性肿瘤平均(158.08±82.63)min;术中失血量平均(165.88±135.29)ml,其中良性疾病平均(141.05±96.92)ml,恶性肿瘤平均(238.46±199.12)ml;术后排气时间平均(1.76±0.62)d,其中良性疾病平均(1.66±0.58)d,恶性肿瘤平均(2.69±0.86)d;术后平均住院(5.18±2.21)d,其中良性疾病平均(4.42±1.48)d,恶性肿瘤平均(7.38±2.53)d。除2例患者术后发生出血外,无胆漏、胸腔积液等并发症发生。结论:传统腹腔镜器械完成单孔腹腔镜肝左叶病变切除具有良好的疗效及美容效果。病灶局限肝左外叶的良性病例是单孔腹腔镜肝切除术的良好适应证。

Single port laparoscopic hepatectomy:a single-center experience of 51 cases

Objective:To explore the efficacy and security of single port laparoscopic hepatectomy and sum up the experience of our center. Methods:From Dec. 2009 to Aug. 2015,51 patients received single port laparoscopic hepatectomy. Clinical data were ret-rospective analyzed. The clinical efficacy between the benign disease and the malignant were compared. Fifty-one patients received sin-gle port laparoscopic hepatectomy,including 18 males and 33 females,38 patients were diagnosed with benign disease,13 patients were diagnosed with malignant tumor,average age was (43. 51±11. 83) years (range 25-84 years). Results:All patients underwent success-ful laparoscopic single port hepatectomy,with no plus ports or conversion to laparotomy. The operative time was (112. 65±53. 23) min, benign group (97. 11±25. 33) min,malignant group (158. 08±82. 63) min;the intraoperative blood loss was (165. 88±135. 29) ml, benign group (141. 05±96. 92) ml,malignant group (238. 46±199. 12) ml;the postoperative exhaust time was (1. 76±0. 62) d,be-nign group (1. 66±0. 58) d vs. malignant group (2. 69±0. 86) d;the postoperative hospital stay was (5. 18±2. 21) d,benign group (4. 42±1. 48) d vs. malignant group (7. 38±2. 53) d. Except 2 postoperative bleeding,there was no bile leakage,pleural effusion,etc. Conclusions:Single port laparoscopic left lobe hepatectomy is effective and has satisfactory cosmetic result with traditional laparoscopic instruments. Benign diseases in left lateral lobe of liver are more suitable for single port laparoscopic hepatectomy than malignant tumors.