The anatomical study and clinical application of the two-step separation approach for laparoscopic left lateral hepatectomy
WANG Dan, XIA Ren-ping, YANG Shi-kun, XU Wang-gang, DUAN Jian
Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (1) : 82-85.
The anatomical study and clinical application of the two-step separation approach for laparoscopic left lateral hepatectomy
Objective To investigate the anatomical structure of the left lateral lobe, and to compare the differences between “the two-step separation approach” and the traditional method in laparoscopic left lateral sectionectomy(LLLS). Methods We retrospectively analyzed the clinical data and imaging information of 46 cases of laparoscopic left lateral lobectomy with "no fissure the falciform ligament of liver using two-step separation approach" from June 2014 to April 2017 in our hospital. Statistical analysis was performed for comparison data to patients with traditional laparoscopic left lobectomy before 2014. Results There was no significant difference between the two groups in gender, age, course of disease, location and size of tumor, preoperative liver function, liver reserve function (P>0.05); intraoperative blood loss, postoperative hospitalization time of patients in the two groups were close, and there was no significant difference between the two groups (P>0.05) . The duration of operation in “the two-step separation approach” group was significantly shorter than that in the control group (P<0.05). Conclusion The modified “The two-step separation approach” in laparoscopic left lateral hepatectomy does not involve severance of falciform ligament, thus circumventing unnecessary operation, and reducing the operation time; The method is easy to learn and has become the gold standard for left lateral hepatectomy when taking into account the development of laparoscopic techniques.
The two-step separation approach / Laparoscopic left lateral sectionectomy / Anatomical structure
[1] Sasaki A, Nitta H, Otsuka K, et al. Ten-year experience of totally laparoscopic liver resection in a single institution[J]. Br J Surg, 2009, 96(3):274-279.
[2] Morise Z. Laparoscopic liver resection for posterosuperior tumors using caudal approach and postural changes: A new technical approach[J]. World J Gastroenterol, 2016, 22(47):10267-10274.
[3] 蔡秀军. 腹腔镜肝切除术的进展[J]. 现代实用医学, 2013, 25(10):1083-1085.
[4] 杜庆云. 腹腔镜肝切除术的临床应用进展[J]. 医学理论与实践, 2011, 24(7):769-771.
[5] 李才营, 吴鸣宇. 腹腔镜肝切除术的研究新进展[J]. 安徽医学, 2011, 44(10):1784-1786.
[6] Wong-Lun-Hing EM, van Dam RM, van Breukelen GJ, et al. Randomized clinical trial of open versus laparoscopic left lateral hepatic sectionectomy within an enhanced recovery after surgery programme (ORANGE II study)[J]. Br J Surg, 2017, 104(5): 525-535.
[7] van Dam RM, Wong-Lun-Hing EM, van Breukelen GJ, et al. Open versus laparoscopic left lateral hepatic sectionectomy within an enhanced recovery ERAS(R) programme (ORANGE II-trial): study protocol for a randomised controlled trial[J]. Trials, 2012, 13: 54.
[8] 尹新民. 腹腔镜肝切除术治疗肝癌的进展与技术难点[J]. 消化肿瘤杂志(电子版), 2015, 7(4):191-193.
[9] Abu Hilal M, McPhail MJ, Zeidan B, et al. Laparoscopic versus open left lateral hepatic sectionectomy: A comparative study[J]. Eur J Surg Oncol, 2008, 34(12): 1285-1288.
[10] 夏志超, 曾仲, 夏仁品, 等. 腹腔镜肝左外叶切除三种血流阻断方法的比较[J]. 中国普通外科杂志, 2016, 25(9):1336-1340.
[11] Li H, Wei Y, Li B, et al. Laparoscopic hepatectomy for segments I, IV, V and VIII[J]. Surg Endosc, 2017, 31(7): 3028-3029
[12]关斌颖, 刘天锡, 方登华, 等. 腹腔镜下左肝外叶切除手术方式探讨[J]. 中国普外基础与临床杂志, 2013, 20(4): 381-384.
[13] Vigano L, Tayar C, Laurent A, et al. Laparoscopic liver resection: a systematic review[J]. J Hepatobiliary Pancreat Surg, 2009, 16(4):410-421.
[14]席兆华, 王毅军. 腹腔镜肝切除术的研究进展[J]. 海南医学院学报, 2009,15（2）: 198-200.
[15] 刘荣, 赵国栋. 肝左外叶切除“金标准”术式:腹腔镜肝左外叶切除术[J]. 中华腔镜外科杂志(电子版), 2010, 6（3）: 474-478.
[16]尹新民, 徐威, 成伟, 等. “两步分层法”腹腔镜肝左外叶切除术的临床应用价值[J]. 中华肝脏外科手术学电子杂志, 2015, 4(6):340-343.
/
| 〈 |
|
〉 |
