手辅式腹腔镜左半肝切除术的安全性及有效性研究

Safety and efficacy study of hand-assisted laparoscopic left liver resecion

目的观察手辅式腹腔镜左半肝切除术应用的安全性及有效性。方法回顾分析行手辅式腹腔镜左半肝切除术的患者20例,并与同期行开腹左半肝切除术的患者24例进行比较,对比两组的手术安全性、术后恢复情况。结果两组均无术中术后严重并发症和手术死亡病例,手辅式腹腔镜组无一例中转开腹;手辅式腹腔镜组手术时间与开腹组相比差异无统计学意义(P>0·05);手辅式腹腔镜组术中出血量少、术后体温恢复快、排气快、下床活动早,术后住院时间短、术后并发症少、对肝功能影响小,与开腹组相比差异有显著统计学意义(P<0·01)。结论运用手辅式腹腔镜技术能集中开腹和腹腔镜手术的优势完成复杂的手术,手辅式腹腔镜左半肝切除术是一种安全、有效的手术方式,有较高的临床应用价值。

Objective To investigate the safety and efficacy of hand-assisted laparoscopic left liver resecion. Methods 20 cases underwent hand-assisted laparoscopic left liver resecion were retrospectively reviewed, and compared with 24 cases with transabdominal left liver resecion in the same period. Results In hand-assisted laparoscopic group, there were less bleeding loss, rapidly recovery to normal temperature and gastric-intestinal function, out of bed activity and eating, shorten hospitalization, less complications, less postoperative ALT level when compared with transabdominal group （P 〈 0. 01 ）. The operative time was no difference between the two groups （ P 〉 0. 05 ）. Conclusions The hand-assisted laparoscopic approach with HandPort system made best use of the advantages of both open and laparoscopic surgery and bypassing their weakness. Hand-assisted laparoscopic left liver resecion is a safe and available way, changing from difficulty into easy, achieving the goal of minimally invasive surgery.