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目的探讨腹腔镜肝癌切除术的适应证和可行性。方法回顾性分析2002年3月至2007年10月完成的腹腔镜肝癌切除术28例患者临床资料。结果28例均成功在腹腔镜下完成手术。对于位于肝左外叶的肿瘤,选择规则性肝左外叶切除术;肿瘤位于肝脏边缘或右肝表面时,选择肝脏不规则切除术。平均手术时间95min(60~150min)。平均术中出血345ml(50~800ml)。切除标本最大体积11cm×9cm×7cm。患者术后24 h均能下床活动,术后2~3d即能进食。术后平均住院时间8d(5~15d)。术后病理诊断为原发性肝细胞癌24例,结直肠癌肝转移4例。结论对位于肝脏边缘、右肝表面或者左肝外叶的肝癌行腹腔镜肝癌切除术是安全可行的。
Objective To investigate the indications and feasibility of laparoscopic resection of liver cancer. Methods The clinical data of 28 patients with laparoscopic liver cancer resection completed from March 2002 to October 2007 were retrospectively analyzed. Results All 28 cases underwent laparoscopic surgery successfully. For tumors located in the left lateral lobe of the liver, regular left hepatic lobectomy was selected; when the tumor was located on the edge of the liver or on the surface of the right liver, the hepatic irregular resection was selected. The average operation time 95min (60 ~ 150min). The average intraoperative bleeding 345ml (50 ~ 800ml). Excision of the largest specimen size 11cm × 9cm × 7cm. Patients can get out of bed 24 hours after surgery, 2 ~ 3d after surgery that can eat. The average postoperative hospital stay 8d (5 ~ 15d). Postoperative pathological diagnosis of primary hepatocellular carcinoma in 24 cases, 4 cases of colorectal cancer liver metastases. Conclusion It is safe and feasible to perform laparoscopic resection of liver cancer in liver cancer located on the edge of the liver, the surface of the right liver or the left extrahepatic lobe.