螺旋水刀联合多功能手术解剖器在解剖性肝切除手术中的应用

Combination of helix hydro-jet and PMOD in anatomical liver resection

目的探讨螺旋水刀联合彭氏多功能手术解刮器(PMOD)在解剖性肝切除手术中的应用。方法回顾2014年1月至2015年5月所实施的77例解剖性肝切除手术病人的临床资料,其中37例为螺旋水刀联合PMOD组,40例为单纯PMOD组。比较两组术中肝门阻断、肿瘤切除时间、出血量,术后并发症等情况。结果螺旋水刀联合PMOD组需肝门阻断4例;单纯PMOD组需肝门阻断35例。螺旋水刀联合PMOD组在肿瘤切除时间、术中出血量情况,均优于单纯PMOD组(P<0.01)。两组患者术中视野清晰,肝内管道系统暴露充分,未发生管道系统误损。术后影像学监测未发现有重要血管损伤的表现;围手术期均无死亡病例。结论螺旋水刀在解剖性肝切除术的应用是安全、可行的,能减少肝门血流阻断,减少肿瘤切除时间及术中出血量。

Objective To investigate the application of helix hydrojet and PMOD （peng＇smuhifunctional operative dissection） in anatomical liver resection. Methods The operative data of 77 patients with anatomical liver resection by means of combining helix hydro - jet and PMOD were analyzed retrospectively. Time of hepatic portal occlusion, tumor removal time, bleeding volume, and postoperative complications were compared. Results The hepatic hilar vessels were interdicted in PMOD with 35 cases, and 4 cases in the combining process. The combining group was better than PMOD in operative time and intraoperative bleeding（ P 〈 0.01 ）. The operative eyeshot was clear and the intrahepatic canal was completely exposed. There was no injury in hepatic canal system. In B - ultrasonic after operation, no important blood vessels were found damaged. The combining group was better than PMOD in operative time and intraoperative bleeding. Conclusion Combination of helix hydro - jet and PMOD is a rapid and safe operative method in anatomical liver resection.