An alternative option of the retroperitoneal laparoscopic approach for limited hepatectomy for recurrent hepatocellular carcinoma at the transected edge after previous hepatectomy
An alternative option of the retroperitoneal laparoscopic approach for limited hepatectomy for recurrent hepatocellular carcinoma at the transected edge after previous hepatectomy
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DOI：
10.1111/ases.13185
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发表时间：
2023-03-23
影响因子：
1
通讯作者：
Nanashima，Atsushi
中科院分区：
文献类型：
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作者：
Hamada，Takeomi;Yano，Koichi;Nanashima，Atsushi
腹腔镜肝切除术是一种安全的微创手术，适用于既往肝切除术后复发的肝肿瘤患者。然而，开放式右半肝切除术后，由于与周围腹膜或器官严重粘连，即使是腹腔镜入路的有限切除，也很难在横断边缘或平面解剖和暴露手术野。我们在此应用腹膜后腹腔镜入路，通过避免严重腹腔内粘连，对复发性肝细胞癌（HCC）患者既往重复肝切除术后的Couinaud第6节横断边缘的背侧表面进行有限切除。我们通过腹膜后间隙安全地切除了复发性HCC。这种方法是腹腔镜手术的一种有用的替代选择，可以最大限度地减少解剖时间，避免肝脏恶性肿瘤患者肝切除术后肝脏横断区域右侧的器官损伤。
Laparoscopic hepatectomy is safely performed with minimal invasiveness on patients with recurrent liver tumors after previous hepatectomy. However, it is still difficult to dissect and expose the operative field at the transected edge or plane after open right hepatectomy, even for limited resection by a laparoscopic approach, due to severe adhesion to the surrounding peritoneum or organs. We herein applied the retroperitoneal laparoscopic approach to limited resection of the dorsal surface at the transected edge of Couinaud's segment 6 after previous repeated hepatectomies in a patient with recurrent hepatocellular carcinoma (HCC) by avoiding severe intra‐abdominal adhesion. We safely resected recurrent HCC via the retroperitoneal space. This approach is a useful and alternative option for laparoscopy which minimizes the dissecting time and avoids organ injury on the right side of the transected area of the liver after hepatectomy in patients with liver malignancies.