临床外科杂志 ›› 2024, Vol. 32 ›› Issue (5): 499-501.doi: 10.3969/j.issn.1005-6483.2024.05.017

• 论著 • 上一篇    下一篇

三维重建技术在肝癌腹腔镜肝切除术中的应用体会

  

  1. 432000   武汉科技大学附属孝感医院肝胆外科
  • 收稿日期:2023-04-14 修回日期:2023-04-14 接受日期:2023-04-14 出版日期:2024-05-25 发布日期:2024-05-25
  • 通讯作者: 殷强,Email:yqiang2008@163.com

Application experience of three dimensional reconstruction technique in laparoscopic hepatectomy for hepatic carcinoma

  1. Department of Hepatobiliary Surgery, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology,Hubei,Xiaogan 432000, China
  • Received:2023-04-14 Revised:2023-04-14 Accepted:2023-04-14 Online:2024-05-25 Published:2024-05-25

摘要: 目的  探讨三维重建技术在肝癌腹腔镜肝切除术中的应用价值。方法  收集2019年9月~2022年3月原发性肝癌病人62例,按是否使用三维重建技术分为两组,观察组31例,使用三维重建技术;对照组31例,未使用三维重建技术。术前均完善增强CT扫描。比较两组病人的术中情况(手术时间、术中出血量)、术后情况(术后并发症发生率、术后住院时间)。果 62例病人均顺利完成腹腔镜肝切除术,未出现肝功能衰竭及死亡病例。对于肿瘤位于Ⅱ、Ⅲ肝段病人,对照组与观察组的手术时间、术中出血量、术后住院时间、术后并发症总发生率比较差异无统计学意义(P>0.05);对于肿瘤位于Ⅳ~Ⅵ肝段病人,观察组的手术时间[(211.36±11.22)分钟比(231.69±19.73 )分钟]、术中出血量[(274.29±23.84)ml比(306.54±21.05)ml]、术后住院时间[(7.93±1.33)天比(9.62±1.80)天]低于对照组,差异有统计学意义(P<0.05),两组术后并发症总发生率比较差异无统计学意义(P>0.05);对于肿瘤位于Ⅰ、Ⅶ、Ⅷ肝段病人,观察组的手术时间[(165.88±10.60)分钟比(187.30±17.29)分钟]、术中出血量[(271.25±12.17)ml比(308.00±28.21)ml]、术后住院时间[(7.63±0.74)天比(9.30±1.06)天]低于对照组,差异有统计学意义(P<0.05),两组术后并发症总发生率比较差异无统计学意义(P>0.05)。结论 三维重建技术可能对复杂的腹腔镜肝癌肝切除术具有指导意义。 

关键词: 原发性肝癌, 三维重建技术, 腹腔镜肝切除术

Abstract: Objective To explore the application value of three dimensional reconstruction technique in laparoscopic hepatectomy for hepatic carcinoma.Methods  From September 2019 to March 2022,the clinical data of 62 patients with primary hepatic carcinoma were gathered.The enhanced CT scanning was performed before surgery.Patients with three dimensiona reconstruction technology were set as observation group (n=31).Patients who did not use three dimensiona reconstruction technology were set as the control group (n=31),and intraoperative conditions (time of operation,bleeding volume during operation) and postoperative conditions (occurrence rate of postoperative complications,postoperative length of stay) of the two groups were compared.Results 62 patients successfully completed laparoscopic hepatectomy without liver failure or death.For patients with tumors located in liver segment Ⅱ and Ⅲ,there were no significant difference of operation time,intraoperative blood loss,postoperative hospital stay and postoperative complication total rate between control group and observation group(P>0.05).For patients with tumors located in liver segment Ⅳ-Ⅵ,operation time[(211.36±11.22)minutes vs (231.69±19.73 )minutes],intraoperative blood loss[(274.29±23.84)ml vs (306.54±21.05)ml],postoperative hospital stay[(7.93±1.33)days vs (9.62±1.80)days] in observation group were lower than those in control group(P<0.05),and there was no significant difference of postoperative complication total rate between two groups(P>0.05).For patients with tumors located in liver segment Ⅰ,Ⅶ and Ⅷ,operation time[(165.88±10.60)minutes vs (187.30±17.29)minutes],intraoperative blood loss[(271.25±12.17)ml vs (308.00±28.21)ml],postoperative hospital stay[(7.63±0.74)days vs (9.30±1.06)days] in observation group were lower than those in control group(P<0.05),and there was no significant difference of postoperative complication total rate between two groups(P>0.05).Conclusion The three dimensiona reconstruction technique may have  prominent guiding significance for complex laparoscopic hepatectomy for hepatic carcinoma.

Key words: primary hepatic carcinoma, Three-dimensional reconstruction technology, Laparoscopic hepatectomy

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