转移性肝癌的腹腔镜肝切除术

Laparoscopic resection of metastatic liver carcinoma

目的探讨转移性肝癌的腹腔镜肝切除术经验。方法对1997年至2004年度布里斯班医院所进行的所有肝切除术患者进行回顾性研究。结果有84例患者进行了腹腔镜肝切除,其中33例(39%)为恶性肿瘤。33例中28例为转移性,其中22例为结直肠癌转移。13例患者进行左肝外侧叶切除,9例患者进行了右半肝切除,其余6例行肝段或不规则切除。67%失去随访,追踪随访12例患者2年存活率和无瘤生存率为75%和67%。结论在高度选择过的恶性肿瘤患者中行腹腔镜肝切除术是可行的。但要求术者有丰富的开腹肝切除术经验和腹腔镜操作技能。

Objective To evaluate the experience with laparoscopic resection of metastatic liver carcinoma. Methods All laparoscopic liver resections performed by 4 surgeons in Brisbane between 1997 and 2004 were retrospectively reviewed. Follow up was carried out by regular patient visit and phone call. Resuits Of 84 laparoscopic liver resections, 33 （39%） were done for malignancy, 28 of which for tumor metastases （22 colorectal）. Thirteen patients underwent left lateral sectionectomy with a minimal morbidity, 9 underwent right hepatectomy and 6 underwent segmental or subsegmental resection. The tumor free survival rates of 12 patients who were followed up for 2 years were 75% with 67%. Conclusion Laparoscopic liver resection is feasible in highly selected cases of malignant disease, who need to be appropriately staged, and surgeons should be skilled at open liver surgery and advanced laparoscopic procedures.