复发性肝癌的腹腔镜再切除

目的探讨腹腔镜肝切除术(LH)治疗复发性肝癌的安全性及可行性。方法 2003年8月至2008年5月,同一手术组完成大约500例肝癌切除手术,其中LH120例。500例患者中,约有100例复发,我们仔细选择6例病例进行了腹腔镜复发性肝癌再切除术,手术适应证评估指标包括肿瘤位置、大小、转移范围、血管侵犯与否以及肝功能状况等。手术方式包括4例局部切除及2例解剖性左外叶切除。对病例资料进行回顾性分析。结果 6例手术均取得成功,无严重术中及术后并发症发生。平均手术时间为(140.8±35.7)min,平均出血量为(283.3±256.3)ml,术后平均住院日为(5.7±1.6)d。结论对于严格选择的病例,LH是治疗复发性肝细胞癌的一种安全有效的方法,具有创伤小、恢复快的优点。

Laparoscopic repeat resection of recurrent hepatocellular carcinoma

Objective To explore the safety and feasibility of laparoscopic resection of recurrent liver tumors.Methods Between August 2003 and May 2008,500 patients underwent hepatectomy for hepatocellular carcinoma,with 120 receiving laparoscopic hepatectomy.Tumor recurrence were found in 100 of the 500 patients.Performed laparoscopic re-resection in 6 carefully selected patients.Surgical indications were evaluated by specific selection criteria for tumor location,size,metastases,vessel invasion and liver function.Four patients received laparoscopic partial hepatectomy and two received laparoscopic anatomical left lateral lobe resection.Results were analyzed retrospectively.Results The six surgeries（4 laparoscopic partial hepatectomies,2 laparoscopic anatomical left lateral lobe resections）were successfully performed with no intraoperative complications.Mean operative time was（140.83±35.69）minutes, mean blood loss was（283.33±256.25）ml,and mean hospital stay was（5.67±1.63）days. Conclusions Carefully selecte cases meeting specific criteria suggests that laparoscopic hepatic resection is a safe,feasible procedure with multiple benefits for treating recurrent hepatocellular carcinoma.