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首页> 外文期刊>ANZ journal of surgery >Early experience with totally laparoscopic major hepatectomies: single institution experience with 31 consecutive cases
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Early experience with totally laparoscopic major hepatectomies: single institution experience with 31 consecutive cases

机译：早期经验完全腹腔镜主要肝切除术：单一机构经验，连续31例

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Background Totally laparoscopic major hepatectomy ( LMH ) is a technically challenging procedure with limited studies mainly from high‐volume expert centers reported. In this study, we report our initial experience with totally LMH . Methods A retrospective review of a prospective database of 340 consecutive patients who underwent laparoscopic liver resection at a single institution was conducted. Thirty‐one consecutive patients who underwent attempted totally LMH between March 2011 to December 2016 were identified. Major hepatectomies were defined as resection of ≥3 contiguous segments which included only right/left hepatectomies, extended hepatectomies or central hepatectomies. Results The procedures included 11 right hepatectomies, one extended right hepatectomy, nine left hepatectomies (two including middle hepatic vein), two extended left hepatectomies, two left hepatectomies with caudate lobe and six central hepatectomies. The median tumor size was 40 (range, 12–100) mm and the median operation time was 435 (range, 245–585) min. Median blood loss was 500 (range, 100–1900) mls and 10 (32.3%) patients required blood transfusion. There were three (9.7%) open conversions of which two occurred during the first five cases. There was one (3.2%) major (grade 2) morbidity and there were no 30‐day/in‐hospital mortalities or reoperations. The median postoperative stay was 5 (range, 3–14) days. Conclusion Our initial experience confirms the feasibility and safety of LMH . There was an increase in the number and proportion of LMH performed at our institution over time.
机译：背景技术完全腹腔镜主要肝切除术（LMH）是一种技术上挑战性的程序，主要从大量专家中心报告。在这项研究中，我们报告了完全LMH的初始经验。方法对一项在单一机构进行腹腔镜肝切除的340名连续患者的前瞻性数据库的回顾性审查。在2011年3月至2016年12月间在2011年3月至2016年12月期间经历了三十六个患者。主要肝切除术被定义为≥3连续段的切除，其仅包括右/左肝切除术，延长肝切除术或中央肝切除术。结果该程序包括11个右肝切除术，一个延伸右肝切除术，九个左肝切除术（两种包括中间肝静脉），两个延伸左肝切除术，两种左肝切除术，尾叶和六个中央肝切除术。中值肿瘤大小为40（范围，12-100）mm，中值操作时间为435（范围，245-585）分钟。中位失血为500（范围，100-1900）MLS和10（32.3％）患者需要输血。在前五个案例中，有三个（9.7％）开放的转换，其中两个发生了两种情况。有一个（3.2％）的主要（＆ 2级）发病率，没有30天/医院内部死亡或重新进展。术后留下的中位数是5（范围，3-14）天。结论我们的初始经验证实了LMH的可行性和安全性。随着时间的推移，LMH的数量和比例有所增加。

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