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目的探讨经前正中入路行肝尾状叶肿瘤切除的技术。方法回顾性分析自2006年至2009年,3例位于肝尾状叶腔静脉旁部肿瘤患者的临床资料。先行术中B超定位确定肝切线,以超声吸引刀(CUSA)结合钛夹、氩气刀在不阻断肝血流情况下,经肝正中裂前入路行尾状叶切除术。结果3例患者手术均顺利完成。尾状叶及肿瘤被完整地切除,肉眼无残留。1例术后有中等量右侧胸腔积液,经穿刺抽液后治愈。结论经前入路可提高肝尾状叶肿瘤的手术切除率,尤其适用于腔静脉旁部肿瘤切除,并可有效防止损伤肝静脉主干及下腔静脉。
Objective To investigate the technique of resection of the tumor of the caudate lobe of the liver by the anterior median approach. Methods The clinical data of 3 patients with paravertebral veins in the caudate lobe from 2006 to 2009 were analyzed retrospectively. The first intraoperative ultrasound localization of the liver to determine the tangential line to the ultrasound-guided knife (CUSA) combined with titanium clip, argon gas knife in the case of blood flow does not block the case, the middle liver fissure approach caudal lobectomy. Results All three patients underwent surgery successfully. Caudate lobe and tumor are completely removed, the naked eye without residue. One patient had a moderate amount of pleural effusion on the right side and was cured after puncture of the fluid. Conclusion Anterior approach can improve the surgical resection rate of hepatic caudate lobe tumors, especially for paraselvular tumor resection and can effectively prevent the injury of the hepatic vein trunk and inferior vena cava.