Ressecões hepáticas por videolaparoscopia
Ressecões hepáticas por videolaparoscopia
复制标题
通过视频腹腔镜进行肝脏研究
DOI：
--
复制
发表时间：
2009
期刊：
影响因子：
--
通讯作者：
I. Cecconello
中科院分区：
文献类型：
--
作者：
Paulo Herman;Fabricio Ferreira Coelho;R. M. Lupinacci;M. Perini;M. A. C. Machado;Luiz Augusto Carbeiro D´Albuquerque;I. Cecconello
引言：肝切除术是腹腔镜手术最后一个被超越的领域。尽管这是一种高度复杂的手术，但需要腹腔镜和肝脏手术的先进技术和经验，过去几年全球范围内的适应症和病例数量都有大幅增长。目的：根据已发表的文章和50多例腹腔镜肝切除术的经验，对该技术进行批判性分析。概述了适应症、可行性、安全性和基本技术方面。方法：通过检索Lilacs和Medline数据库（截至2009年12月），使用关键词“肝切除术”、“腹腔镜手术”和“肝脏手术”确定原始发表的研究。未发现前瞻性随机对照试验，因此所有数据均来自病例系列、病例对照研究和荟萃分析。结论：腹腔镜肝切除术是安全可行的，即使是大切除，发病率和死亡率低。腹腔镜手术在肿瘤学上与开腹手术相似，在肿瘤患者中可能具有一定的优势。良性病变，尤其是肝细胞腺瘤，仍是最佳适应证。在经验丰富的中心，腹腔镜入路可能被视为良性前外侧病变和左侧切除术的标准治疗。
INTRODUCTION: Hepatic resection is the last frontier to be surpassed by laparoscopic surgery. Although a highly complex procedure, the need of advanced technology and experience in both laparoscopic and hepatic surgery, the indications and number of cases done worldwide had a major growth in the last few years. AIM: Critically analyze the technique, based on published articles and acquired experience with more than 50 laparoscopic hepatic resections. Indications, feasibility, safety, and basic technical aspects are outlined. METHODS: Original published studies were identified by searching the Lilacs and Medline databases (up to December 2009) using the keywords "liver resection", "laparoscopic" and "liver surgery". It was not found any prospective randomized trial, so all data came from case series, case-control studies, and meta-analysis. CONCLUSION: Laparoscopic liver resection is safe and feasible even for major resections, with low morbidity and mortality rates. Laparoscopic approach is considered to be oncologically similar to its open counterpart and may have some advantage in cirrhotic patients. Benign lesions, especially hepatocellular adenoma, remains the best indication. In experienced centers the laparoscopic approach may be considered the standard of care for benign antero-lateral located lesions, and for left lateral sectorectomy.