三维重建对右侧肝脏占位性病变精准肝切除微创手术效果的影响

doi:10.3969/j.issn.1671-7171.2018.11.004

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摘要【目的】探讨三维重建对右侧肝脏占位性病变精准肝切除微创手术效果的影响。【方法】选取本院收治的64例行腹腔镜右肝切除术患者的临床资料,根据患者是否应用三维重建及虚拟肝切除系统评估将其分为观察组(n=38,术前运用)和对照组(n=26,术前未用)。记录两组手术时间、术中出血量、肝门阻断时间、实际切除肝体积、术后住院时间和术后并发症发生情况。【结果】观察组手术时间、术中出血量、肝门阻断时间和住院时间均显著低于对照组,差异具有统计学意义(P<0.05)。观察组实际切除肝体积略小于预切除肝体积,差异无统计学意义(P>0.05)。直线相关性分析结果显示,预切除肝体积与实际切除肝体积具有明显相关性(r=0.925,P<0.01)。观察组、对照组分别有3例、2例术后发生腹腔积液,经引流治愈。两组均未发生CO₂栓塞、胆瘘、出血等并发症。【结论】三维重建及模拟肝切除系统有助于降低腹腔镜肝切除术手术时间、术中出血量、肝门阻断时间和术后住院时间,可精确预测肿瘤体积,在腹腔镜肝切除术中具有一定的辅助作用。

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关键词 ：肝肿瘤/外科学, 体层摄影术, 螺旋计算机, 肝切除术

Abstract：【Objective】To investigate the effect of three-dimensional reconstruction on minimally invasive precise hepatectomy operation for right hepatic hepatectomy. 【Methods】The clinical data of 64 patients with right hepatectomy were selected and divided into observation group (n=38, used before operation) and control group (n=26, unused before operation). The operative time, the intraoperative blood loss, the blocking time of the hepatic gate, the actual resection of the liver volume, the postoperative hospital stay and the postoperative complications were recorded.【Results】 The operative time, intraoperative bleeding volume, hepatic portal occlusion time and hospitalization time in the observation group were significantly lower than those in the control group (P<0.05).The actual liver resected liver volume of the observation group was slightly smaller than that of the preresectomized liver, and the difference was not statistically significant (P>0.05).The results of linear correlation analysis showed that there was a significant correlation between the volume of preresectomized liver and the actual volume of liver resected (r=0.925,P<0.01).There were 3 cases in the observation group and 2 cases in the control group which developed peritoneal effusion after operation and were cured by drainage.No CO₂ embolism, biliary fistula, bleeding and other complications occurred in both groups.【Conclusion】 Three-dimensional reconstruction and simulated hepatectomy system can reduce the time of laparoscopic hepatectomy, the amount of intraoperative bleeding, the time of hepatic hilus occlusion and postoperative hospitalization time, which can accurately predict the tumor volume. It has a certain auxiliary effect in laparoscopic hepatectomy.

Key words： Liver Neoplasms /SU Tomography, Spiral Computed Hepatectomy

收稿日期: 2018-06-11

PACS:

R735.7

基金资助:陕西省自然科学基金(中心体/Rac1介导胰腺癌神经导向转移实验研究,项目编号 2016JM8127)

通讯作者: E-mail:binbinyang6601@126.com

引用本文:

张焱, 向国安, 袁庆功, 曹罡, 杨文彬. 三维重建对右侧肝脏占位性病变精准肝切除微创手术效果的影响[J]. 医学临床研究, 2018, 35(11): 2091-2093.
ZHANG Yan, XIANG Guo-an, YUAN Qing-gong, et al. Effect of Three-dimensional Reconstruction on Minimally Invasive Precise Hepatectomy Operation for Right Hepatic Hepatectomy. JOURNAL OF CLINICAL RESEARCH, 2018, 35(11): 2091-2093.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2018.11.004 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2018/V35/I11/2091