Laparoscopic liver resection (LLR) for the treatment of benign and malignant liver lesions is often performed at specialized centers. Technological advances, such as laparoscopic ultrasonography and electrosurgical to...Laparoscopic liver resection (LLR) for the treatment of benign and malignant liver lesions is often performed at specialized centers. Technological advances, such as laparoscopic ultrasonography and electrosurgical tools, have afforded surgeons simultaneous improvements in surgical technique. The utilization of minimally invasive techniques for liver resection has been reported to reduce operative time, decrease blood loss, and shorten length of hospital stay with equivalent postoperative mortality and morbidity rates compared to open liver resection (OLR). Non-anatomic liver resection and left lateral sectionectomy are now routinely performed laparoscopically at many institutions. Furthermore, major hepatic resections are performed by pure laparoscopy, hand-assisted technique, and the hybrid method. In addition, robotic surgery and single port surgery are revealing early promising results. The consensus recommendation for the treatment of benign liver disease and malignant lesions remains unchanged when considering a laparoscopic approach, except when comorbidities and anatomic limitations of the liver lesion preclude this technique. Disease free and survival rates after LLR for hepatocellular carcinoma and metastatic colon cancer correspond to OLR. Patient selection is a significant factor for these favorable outcomes. The limitations include LLR of superior and posterior liver lesions; however, adjustments in technique may now consider a laparoscopic approach as a viable option. As growing data continue to reveal the feasibility and efficacy of laparoscopic liver surgery, this skill is increasingly being adopted by hepatobiliary surgeons. Although the full scope of laparoscopic liver surgery remains infrequently used by many general surgeons, this technique will become a standard in the treatment of liver diseases as studies continue to show favorable outcomes.展开更多
目的探讨超声术前评估及精准定位在真空辅助微创旋切系统治疗乳腺多发良性包块中的价值。方法选取我院经病理确诊的52例乳腺多发良性包块患者(共156个病灶),其中经超声术前评估及精准定位后行超声引导下乳腺包块旋切手术的患者26例(78...目的探讨超声术前评估及精准定位在真空辅助微创旋切系统治疗乳腺多发良性包块中的价值。方法选取我院经病理确诊的52例乳腺多发良性包块患者(共156个病灶),其中经超声术前评估及精准定位后行超声引导下乳腺包块旋切手术的患者26例(78个病灶,研究组),仅经常规超声检查后行超声引导下乳腺包块旋切手术的患者26例(78个病灶,对照组);比较两组患者的手术旋切时间、旋切刀数及术中出血率。结果两组患者所有包块均被完整切除。研究组手术时间显著短于对照组[(19.88±5.73)min vs.(30.38±9.27)min],旋切刀数显著少于对照组(14.54±6.35 vs. 21.81±9.46),差异均有统计学意义(t=-4.915、-3.254,均P<0.05)。研究组术中出血率[7.7%(2/26)]明显低于对照组[38.5%(10/26)],差异有统计学意义(χ2=6.933,P<0.05)。结论超声术前评估及乳腺包块精准定位联合术中超声引导下真空辅助微创旋切系统治疗乳腺多发包块,可缩短手术时间,减少手术刀数,降低术中出血率,可作为乳腺良性多发包块快速、微创治疗的重要手段。展开更多
文摘Laparoscopic liver resection (LLR) for the treatment of benign and malignant liver lesions is often performed at specialized centers. Technological advances, such as laparoscopic ultrasonography and electrosurgical tools, have afforded surgeons simultaneous improvements in surgical technique. The utilization of minimally invasive techniques for liver resection has been reported to reduce operative time, decrease blood loss, and shorten length of hospital stay with equivalent postoperative mortality and morbidity rates compared to open liver resection (OLR). Non-anatomic liver resection and left lateral sectionectomy are now routinely performed laparoscopically at many institutions. Furthermore, major hepatic resections are performed by pure laparoscopy, hand-assisted technique, and the hybrid method. In addition, robotic surgery and single port surgery are revealing early promising results. The consensus recommendation for the treatment of benign liver disease and malignant lesions remains unchanged when considering a laparoscopic approach, except when comorbidities and anatomic limitations of the liver lesion preclude this technique. Disease free and survival rates after LLR for hepatocellular carcinoma and metastatic colon cancer correspond to OLR. Patient selection is a significant factor for these favorable outcomes. The limitations include LLR of superior and posterior liver lesions; however, adjustments in technique may now consider a laparoscopic approach as a viable option. As growing data continue to reveal the feasibility and efficacy of laparoscopic liver surgery, this skill is increasingly being adopted by hepatobiliary surgeons. Although the full scope of laparoscopic liver surgery remains infrequently used by many general surgeons, this technique will become a standard in the treatment of liver diseases as studies continue to show favorable outcomes.
文摘目的探讨超声术前评估及精准定位在真空辅助微创旋切系统治疗乳腺多发良性包块中的价值。方法选取我院经病理确诊的52例乳腺多发良性包块患者(共156个病灶),其中经超声术前评估及精准定位后行超声引导下乳腺包块旋切手术的患者26例(78个病灶,研究组),仅经常规超声检查后行超声引导下乳腺包块旋切手术的患者26例(78个病灶,对照组);比较两组患者的手术旋切时间、旋切刀数及术中出血率。结果两组患者所有包块均被完整切除。研究组手术时间显著短于对照组[(19.88±5.73)min vs.(30.38±9.27)min],旋切刀数显著少于对照组(14.54±6.35 vs. 21.81±9.46),差异均有统计学意义(t=-4.915、-3.254,均P<0.05)。研究组术中出血率[7.7%(2/26)]明显低于对照组[38.5%(10/26)],差异有统计学意义(χ2=6.933,P<0.05)。结论超声术前评估及乳腺包块精准定位联合术中超声引导下真空辅助微创旋切系统治疗乳腺多发包块,可缩短手术时间,减少手术刀数,降低术中出血率,可作为乳腺良性多发包块快速、微创治疗的重要手段。
