经脐单孔腹腔镜肝左外叶切除术的临床应用体会r(附32例报告)

摘要

Objective:To investigate the safety and feasibility of single-incision transumbilical laparoscopic left lateral hepatic lobectomy ( SITL-LLHL) .Methods:Retrospective analysis was performed on the clinical data of 32 patients who underwent SITL-LLHL from Mar.2015 to Dec.2016.Results:All the operations were completed successfully in32 patients, without adding more incisions or conversion to laparotomy.The operation time was (90.0 ±21.2) min.The intraoperative bleeding volume was (50.1 ±12.9) ml.No blood transfusion was performed during or after the operation .No postoperative complications such as bleeding ,bile leakage or abdomi-nal infection occurred .On the first day after the operation ,gastric tube was removed and the patients tried drinking water .Eating began on the second day after surgery .The average hospital stay was (6.0 ±2.3) d.The patients were followed up for 6-12 months and no re-currence was reported during that time .Conclusions:SITL-LLHL is safe and feasible ,and it may become the gold standard for hepatec-tomy of the left lateral lobe in the future .%目的:探讨经脐单孔腹腔镜肝左外叶切除术的安全性与可行性.方法:回顾分析2015年3月至2016年12月为32例患者行经脐单孔腹腔镜肝左外叶切除术的临床资料.结果:32例均顺利完成手术,无一例增加切口及中转开腹.手术时间平均(90.0±21.2)min,术中出血量平均(50.1±12.9)ml,术中、术后均未输血,术后无出血、胆漏、腹腔感染等并发症发生;术后第1天拔除胃管,并试饮水,术后第2天开始进食.术后平均住院(6.0±2.3)d.术后随访6~12个月,无复发.结论:经脐单孔腹腔镜肝左外叶切除术是安全、可行的,有望成为肝左外叶切除的金标准.