The application of laparoscopic precise hemihepatectomy guided by middle hepatic vein in the treatment of primary liver cancer
Yang Xiaoli1,2, Wu Yakun1,3, Cheng Yao1, Li Jinzheng1, Tu Bing1, Liu Zuojin1, Gong Jianping1
1Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China; 2Department of Hepatobiliary Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China; 3Department of Hepatobiliary Surgery, Suining Central Hospital, Suining 629308, China
Abstract:Objective To evaluate the feasibility, safety and clinical efficacy of laparoscopic precise hemihepatectomy guided by middle hepatic vein in the treatment of primary liver cancer.Methods Retrospective cross-sectional study was adopted. The clinical and pathologic data of patients undergoing laparoscopic precise hemihepatectomy guided by middle hepatic vein at the Second Affiliated Hospital of Chongqing Medical University and Suining Central Hospital from March 2012 to March 2015 were analyzed. There were 89 males and 46 females aged from 17-71 years, including 73 patients of left hepatectomy and 62 patients of right hepatectomy. Conversion to laparotomy, operative time, intraoperative blood loss, intraoperative blood transfusion rate, postoperative complications, postoperative hospital stay, postoperative overall survival rate and recurrence-free survival rate were calculated.Results A total of 135 patients were included in the study, 5.2% (7/135) patients were converted to laparotomy. The operation time was (315±86) minutes. The intraoperative blood loss was (513±162) mL and 5.9% (8/135) cases needed intraoperative blood transfusion. 12.6% (17/135) cases had postoperative complications, of which 8.2% (11/135) were Clavien Grade Ⅰ, 3.0% (4/135) were Clavien Grade Ⅱ, and 1.5%(2/135) were Clavien Grade Ⅲ-Ⅴ, no deaths. One hundred and sixteen patients were included in the survival analysis. The median follow-up time was 34 months. The overall survival rates at 1, 3 and 5 years were 92.6%, 76.8% and 64.4%, respectively. The recurrence-free survival rates at 1, 3 and 5 years were 88.3%, 69.2% and 54.9%, respectively.Conclusions The risk of laparoscopic precise hemihepatectomy guided by middle hepatic vein in an experienced liver surgery center is controllable, with fewer complications and a definite curative effect.
杨小李, 吴涯昆, 程瑶, 李金政, 涂兵, 刘作金, 龚建平. 腹腔镜循肝中静脉半肝切除术在原发性肝癌中的应用[J]. 中华解剖与临床杂志, 2019, 24(3): 290-293.
Yang Xiaoli, Wu Yakun, Cheng Yao, Li Jinzheng, Tu Bing, Liu Zuojin, Gong Jianping. The application of laparoscopic precise hemihepatectomy guided by middle hepatic vein in the treatment of primary liver cancer. Chinese Journal of Anatomy and Clinics, 2019, 24(3): 290-293.
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