手助腹腔镜肝部分切除术治疗原发性肝癌

目的 探讨手助腹腔镜肝部分切除术治疗原发性肝癌的方法和应用价值。方法 经临床筛选的第Ⅱ、Ⅲ、Ⅵ段或边缘型的原发性肝癌6例,在腹腔镜辅助下,应用手助器、超声刀、切割器等特殊器械进行腹腔镜下肝癌切除术。结果 6例患者均成功完成手术,包括肝Ⅱ、Ⅲ段切除,Ⅵ段切除及非规则性肝段切除术,手术时间80~130 min,术后住院6~9 d,手术出血150~700 ml,无中转开腹手术,无并发症。术后随访6~15个月,2例分别于手术后3和4个月肝内复发,其余4例随访至今无复发。结论 在经过临床选择的病例中,手助腹腔镜下作肝部分切除术治疗原发性肝癌是安全、可行的手术方式。

Hand-assisted laparoscopic partial hepatectomy in the treatment of primary liver cancer

Objective To explore the techniques of hand-assisted laparoscopic partial hepatectomy and its clinical value in the treatment of primary liver cancer. Methods Six patients with primary liver cancers in the segmentsⅡ, Ⅲ, Ⅴ, Ⅵ and on the edge of the liver received laparoscopic partial hepatectomy assisted by special instruments such as hand-assisted devices, harmonic scalpel, and Endo-GIA. Results All of the 6 operations were completed successfully, in which resections of both Ⅱ and Ⅲ segments, Ⅵ segment, and non-regular segment were performed. The operative time was 54 to 130 min and postoperative hospital stay 6-9 days, with intraoperative blood loss of 150-700 ml. No conversion to laparotomy was needed, nor did any complications occur. Postoperative follow-up lasted for 6 to 15 months, during which relapse occurred in 2 cases 3 months and 4 months after the operations respectively, while no recurrence has been found in the other 4 patients. Conclusion Hand-assisted laparoscopic partial hepatectomy is safe and feasible for primary liver cancer in clinically selected patients.