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首页> 外文期刊>Surgical Endoscopy >Laparoscopic liver resection for hepatocellular carcinoma.
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Laparoscopic liver resection for hepatocellular carcinoma.

机译：腹腔镜肝切除术治疗肝细胞癌。

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BACKGROUND: Single, small hepatocarcinomas (HCC) are still an indication for partial liver resection in patients ineligible for transplantation. Anatomical resections are recommended for oncological reasons. The mini-invasive approach of laparoscopy should minimize hepatic and parietal injury, thereby decreasing the risk of liver failure and ascites. However, the oncological results of this approach and its presumed benefits remain undemonstrated. We evaluated the short- and midterm results of laparoscopic liver resections for HCC. METHODS: Between 1999 and 2006, we performed 32 laparoscopic liver resections for HCC. Mean tumor size was 3.8 +/- 2 cm and the mean age of the patients was 65 +/- 11 years. Twenty-two patients had cirrhosis (21 Child A and one Child C). Operative and postoperative results were analyzed, together with recurrence and survival rates. RESULTS: We carried out 13 unisegmentectomies, nine bisegmentectomies, one trisegmentectomy, two right hepatectomies, one left hepatectomy, and six atypical resections. The duration of the operation was 231 +/- 101 minutes. Conversion to laparotomy was required in three patients (9%), none in emergency situations. Mean blood loss was 461 ml, with five patients (15.6%) requiring blood transfusion. The mean surgical margin was 10.4 mm. One cirrhotic patient (Child C) underwent surgery for a partially ruptured tumor and died of liver failure. Two patients had ascites and no transient liver failure occurred in the other 19 cirrhotic patients. Mean hospital stay was 7.1 days. During a mean follow-up of 26 months, 10 patients (31%) presented recurrence within the liver. None of the patients had peritoneal carcinomatosis or trocar site recurrence. Three-year overall and disease-free survival rates were 71.9% and 54.5%, respectively. CONCLUSIONS: Laparoscopic liver resection for HCC is feasible and well tolerated. Midterm survival and recurrence rates are similar to those after laparotomy.
机译：背景：单个，小肝癌（HCC）仍是不适合移植的患者部分肝切除的指征。出于肿瘤原因，建议进行解剖切除。腹腔镜的微创方法应最大程度地减少肝和顶叶损伤，从而降低肝衰竭和腹水的风险。但是，这种方法的肿瘤学结果及其假定的益处尚待证实。我们评估了腹腔镜肝癌肝切除术的短期和中期结果。方法：1999年至2006年，我们对HCC进行了32例腹腔镜肝切除术。平均肿瘤大小为3.8 +/- 2 cm，患者的平均年龄为65 +/- 11岁。 22名肝硬化患者（21名儿童A和1名儿童C）。分析了手术和术后结果，以及复发率和生存率。结果：我们进行了13例未切除术，9例二切除术，1例三段切除术，2例右肝切除术，1例左肝切除术和6例非典型性切除术。手术时间为231 +/- 101分钟。三名患者（9％）需要转换为剖腹手术，在紧急情况下无一例。平均失血量为461毫升，需要输血的有五名患者（15.6％）。平均手术切缘为10.4 mm。一名肝硬化患者（儿童C）因肿瘤部分破裂而接受手术治疗，死于肝功能衰竭。两名患者有腹水，其他19名肝硬化患者未发生短暂肝功能衰竭。平均住院天数为7.1天。在平均26个月的随访期间，有10例患者（31％）出现了肝内复发。没有患者有腹膜癌变或套管针部位复发。三年总生存率和无病生存率分别为71.9％和54.5％。结论：腹腔镜肝癌切除术是可行的并且耐受性良好。中期生存率和复发率与剖腹手术后的相似。

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