Laennec膜解剖在结直肠癌肝转移手术中的应用

Application of Laennec membrane anatomy in surgery for colorectal cancer liver metastase

目的 探讨Laennec膜解剖在结直肠癌(CRC)肝转移(CRLM)手术中的运用。方法 选取2019年1月至2021年12月CRLM患者20例为研究对象。患者根据肿瘤位置通过Laennec膜游离相应的门,以快速控制需要切除肝脏区域的肝蒂,阻断相应的门,切除病灶。检测术后3 d肝功能指标,观察肝功能恢复情况。结果 20例CRLM患者均成功以Laennec膜解剖的方式来控制需要切除区域肝脏的肝蒂,达到了在切除病灶的过程中,相应区域手术时相应的区域被阻断的效果。20例患者术后第3天肝功能指标[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)]均接近正常值。结论 Laennec膜解剖的运用可有效减轻CRLM患者手术肝脏缺血再灌注后肝功能损伤,促进术后肝功能恢复。

Objective To explore the application of the Laennec membrane anatomy in the operation of colorectal cancer liver metastase(CRLM).Methods Twenty patients with CRLM from January 2019 to December 2021 were collected as the research subjects.The corresponding portal was dissociated through the Laennec membrane according to the tumor location to quickly control the liver pedicle from the liver region needing to be removed,the corresponding portal was blocked,and the lesion was resected.The liver function indexes were measured on postoperative 3 d.The recovery situation of liver function was observed.Results Twenty patients all were successful in controlling the liver pedicle in the regional liver needing to be excised by the Laennec membrane anatomy mode,and reached the effect that the corresponding region wad blocked in the operation during the lesion excision process In the process of excision of the lesion,the corresponding region was blocked during the operation.The Laennec membrane approach avoided the problem of postoperative liver disfunction caused by long-term total hepatic vascular excusion.The liver function indicators in 20 patients were close to the normal values on postoperative 3 d.Conclusion The application of the Laennec membrane anatomy could effectively reduce the liver function injury after liver ischemia reperfusion and promote the recovery of liver function in the operative patients with CRLM.