28例转移性肝癌腹腔镜肝切除术

Laparoscopic resection of metastic liver cancer：experience of 28 cases

目的总结转移性肝癌的腹腔镜肝切除术经验。方法对1999—2006年度布里斯班医院所实施的转移性肝癌腹腔镜肝切除术病人进行回顾性研究。结果经病理证实的28例转移性肝癌病人进行了腹腔镜肝切除，13例进行左肝外侧叶切除，9例进行了右半肝切除。其余6例行肝段或不规则切除。追踪随访12例由直结肠转移的转移性肝癌病人2年存活率和无瘤生存率分别为75％和67％。结论在严格选择过的恶性肿瘤病人中行腹腔镜肝切除术是安全可行的。对病人要有适当的分期．术者需具丰富的开腹肝切除术经验和腹腔镜操作技能。

Objective To summarize the experience in laparoscopic resection of metastic liver cancer. Methods The clinical data of the patients receiving laparoscopic resection of metastic liver cancer performed in Brisbane hospital from 1999 to 2006 were retrospectively analyzed. Results A total of 28 patients received the laparoscopic resection of metastic liver cancer. Procedures included left lateral segmentectomy in 13 patients, right hemihepatectomy in 9 and segmental or subsegmental re- section in 6. Survival rate and disease free survival rate in 12 patients with colorectal metastasis being followed up for 2 years were 75 % and 67%. Conclusion Laparoscopic liver resection is safe and feasible in strictly selected patients with malignancy in an appropriate stage. The surgeons should have rich experience of open liver resection and advanced laparoscopic technique.