经脐单孔腹腔镜肝切除术的临床应用分析

Clinical application analysis of transumbilical single-port laparoscopic hepatectomy

目的探讨经脐单孔腹腔镜肝切除术的疗效及安全性和可行性,并总结其手术经验。方法回顾性分析2022年2月至2023年9月于青岛大学附属医院肝胆胰外科行腹腔镜肝切除手术的39例患者临床资料,其中经脐单孔腹腔镜组19例,包括男性5例,女性14例,年龄(49.6±2.5)岁;多孔腹腔镜组20例,包括男性7例,女性13例,年龄(49.9±3.1)岁。对比分析单孔组与多孔组在术中出血量、手术时间、肠道恢复时间、术后住院时间和术后并发症等方面的差异。结果39例患者均顺利完成手术,无额外加孔及中转开腹情况发生。单孔组手术时间(166.3±59.0)min长于多孔组的(123.2±48.0)min,差异有统计学意义(t=2.50,P=0.020)。单孔组在术中出血量、肠道恢复时间、术后住院时间和术后并发症等方面与多孔组比较差异无统计学意义(均P>0.05)。所有患者术后均无出血、感染及胆漏等并发症发生。随访3~21个月,肝血管瘤、肝腺瘤、肝内胆管结石等原发病均无复发,单孔组脐部切口美学效果明显,患者满意度为100%。结论经脐单孔腹腔镜肝切除手术是安全可行的,具有明显的微创性及美学效果。

ObjectiveTo explore the efficacy,safety,and feasibility of single port laparoscopic liver resection via umbilical cord,and summarize its surgical experience.MethodA retrospective analysis was conducted on 39 patients who underwent liver resection surgery at the Department of Hepatobiliary and Pancreatic Surgery,the Affiliated Hospital of Qingdao University from February 2022 to September 2023.There were 19 patients in the transumbilical single-port laparoscopic group,including 5 males and 14 females,aged(49.6±2.5)years.There were 20 patients in the multi-port laparoscopic group,including 7 males and 13 females,aged(49.9±3.1)years.The intraoperative blood loss,operation time,intestinal recovery time,postoperative hospital stay and postoperative complications were compared between the single-port group and multi-port group.ResultsAll 39 patients successfully completed the surgery without any additional foramen or conversion to open surgery.The operation time of the single hole group(166.3±59.0)min was longer than that of the multi-port group(123.2±48.0)min,and the difference was statistically significant(t=2.50,P=0.020).There were no statistically significant differences in intraoperative blood loss,intestinal recovery time,postoperative hospital stay,and postoperative complications between these two groups(all P>0.05).All patients had no postoperative complications such as bleeding,infection,or bile leakage.Follow up for 3~21 months showed no recurrence of primary diseases such as hepatic hemangioma,hepatic adenoma,and intrahepatic bile duct stones.The aesthetic effect of the umbilical incision in the single orifice group was significant,and patient satisfaction was 100%.ConclusionUmbilical single-port laparoscopic liver resection surgery is safe and feasible,with significant minimally invasive and aesthetic effects.