腹腔镜肝癌切除术16例临床分析

目的介绍采用HIFU及Endo-GIA成功行16例肝癌切除手术的经验与体会.方法选择左半肝及右肝浅表癌肿患者,肝功能Child分级A级15例,B级1例,采用超声刀(High Intensity Focused Ultrasound,HIFU)及腹腔镜切割吻合器Endo-GIA行16例肝恶性肿瘤切除手术.结果 15例患者顺利完成行腹腔镜肝癌切除,1例因出血改为开腹手术.左肝局部切除4例,左半肝切除1例,左外叶切除8例,肝右叶局部切除3例.手术时间80~220 min,平均105 min.术中出血量90~1 000 m L,平均300 m L.病灶直径2~6.5 cm,平均4.5 cm,术后无并发症发生.结论对肝脏浅表肿瘤或左半肝的恶性肿瘤患者行HIFU及Endo-GIA腹腔镜肝癌切除术是可行和安全的.

Clinical Analysis on Laparoscopic Hepatectomy for Hepatocellular Carcinoma in 16 Cases

Objective To introduce new techniques for laparoscopic hepatectomy, High Intensity Focused Ultrasound ( HIFU) and Endo-GIA in 16 cases. Method 16 cases of superficial cancer were enrolled,including 15 cases of grade A and 1 case of grade B according to the liver function child-pugh classification. The surgeries were performed by using HIFU and Endo-GIA. Results Hepatectomy for liver cancer was performed successfully under laparoscope in 15 cases and a conversion to open surgery was required in 1 case because of intraoperative hemorrhage,including left liver partial resections in 4 cases, left half liver resection in 4 case left liver lobe resections in 8 cases,and right liver lobe partial resections in 3 cases. In the laparoscopic hepatectomy,the mean operative time was 105 min (80~220 min),the mean blood loss was 300 mL (90~1 000 mL),and the mean diameter of the lesions was 4. 5 cm (2 ~ 6. 5 cm). No postoperative surgical complications were seen. Conclusion Laparoscopic hepatectomy is safe and feasible by using HIFU and Endo-GIA for malignant tumors located at the border of the liver,the surface of the right lobe,or the left lobe.