腹腔镜肝切除术在肝血管平滑肌脂肪瘤中的应用

Application of Laparoscopic Hepatectomy in Hepatic Angiomyolipoma

目的探讨完全腹腔镜肝切除术治疗肝血管平滑肌脂肪瘤(hepatic angiomyolipoma,HAML)的应用价值。方法回顾性分析2010年1月～2017年12月完全腹腔镜肝切除术治疗HAML 14例的临床资料,其中1例使用达芬奇机器人手术系统行右肝后叶切除术。结果手术时间80～280 min[传统腹腔镜(114. 6±51. 0) min,机器人手术280 min];术中出血量30～800 ml[传统腹腔镜(73. 1±27. 8) ml,机器人手术800 ml],并发症发生率14. 3%(2例肺炎),术后住院(7. 0±2. 0) d。全组随访8～98个月,中位数30个月,均未见复发。结论腹腔镜肝切除术(包括机器人手术)治疗HAML安全可行且具有微创优势,可有效用于肿瘤局部切除及规则性肝叶切除术。

Objective To explore the application value of complete laparoscopic hepatectomy in the treatment of hepatic angiomyolipoma(HAML).Methods Clinical data of 14 cases of HAML treated with complete laparoscopic hepatectomy from January 2010 to December 2017 were retrospectively analyzed,including 1 case using the da Vinci Robot Surgical System.Results The operation time was 80-280 min[laparoscopic surgery:(114.6±51.0)min;robotic surgery:280 min],the amount of bleeding in the operation was 30-800 ml[laparoscopic surgery:(73.1±27.8)ml;robotic surgery:800 ml],the incidence of complications was 14.3%(2 cases of pneumonia),and the average hospital days after operation were(7.0±2.0)days.The whole group was followed up for 8-98 months(median,30 months).No recurrence was found.Conclusions Laparoscopic hepatectomy(including robot surgery)is safe and feasible for the treatment of HAML and has a minimally invasive advantage.It can be used effectively for local resection of tumors and regular lobectomy.