Structuring process approach to laparoscopic anatomical liver central lobectomy for hepatocellular carcinoma
10.3760/cma.j.cn112139-20210615-00259
- VernacularTitle:腹腔镜下定构流程化解剖性肝中叶切除治疗肝细胞癌的临床效果
- Author:
Jun CAO
1
;
Yajin CHEN
Author Information
1. 中山大学孙逸仙纪念医院肝胆外科，广州 510000
- Keywords:
Laparoscopy;
Liver neoplasms;
Central lobectomy;
Structuring resection;
Process approach
- From:
Chinese Journal of Surgery
2021;59(10):836-841
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility and oncological efficacy of structuring process approach to laparoscopic anatomical liver central lobectomy for hepatocellular carcinoma.Methods:The clinical data of 65 patients with hepatocellular carcinoma who underwent laparoscopic anatomical liver central lobectomy at the Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital from April 2017 to April 2021 was retrospectively analyzed. There were 39 males and 26 females,aged ( M( Q R)) 61.2 (29.5) years (range:25 to 80 years).The body mass index was (24.2±3.8) kg/m 2 (range:19.5 to 26.1 kg/m 2) and the tumor diameter was (6.7±2.9)cm(range:3.4 to 10.5 cm).This structuring process approach was designed using a series of main vessels as the plane markers, along which liver transection was carried out. The perioperative indicators and early oncological efficacy were then analyzed. Results:All the procedures were successfully carried out laparoscopically. The operative time was (190.5±70.4) minutes (range:90 to 280 minutes). The blood loss was (370.6±120.8)ml(range:100 to 1 050 ml). No patient received blood transfusion or converted to laparotomy. Postoperative complications occurred in 8 cases(12.3%). Postoperative hospital stay was (7.5±2.5) days(range:5 to 18 days).There was no perioperative death and rehospitalization within 30 days. Pathological study showed all the operations to be R0 resections, the average surgical margin was (2.4±1.9)cm(range:0.5 to 3.1 cm).The tumor recurrence rate was 12.3% after 1 year follow-up.Conclusion:Structuring process approach to laparoscopic anatomical liver central lobectomy could be used to treat patients with hepatocellular carcinoma.
