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目的探讨腹腔镜下微波凝固辅助联合超声刀进行重度硬化肝癌切除术的安全性及有效性。方法回顾性分析我院2010年2月~2012年5月微波治疗仪联合超声刀进行完全腹腔镜下35例伴有重度肝硬化的肝癌手术切除临床资料。结果 35例腹腔镜肝癌切除手术均获成功,无中转手术,术中无需输血;其中21例不规则肝切除,14例肝左外叶切除。手术时间(75~340)分钟,平均(165.5±117.3)分钟。出血量15~300 ml,平均(168.6±147.4)ml;无死亡患者;无肝断面出血、胆漏、肝功能衰竭和腹腔脓肿等术后并发症。术后住院时间5~10天,平均(9.2±2.5)天。结论采用微波凝固辅助联合超声刀对于重度硬化肝癌进行完全腹腔镜切除是一种安全有效的微创治疗方法,可明显降低手术中出血量以及术后并发症发生率。
Objective To investigate the safety and effectiveness of laparoscopic microwave assisted coagulation combined with ultrasonic knife for severe cirrhosis. Methods The clinical data of 35 patients with hepatocellular carcinoma with severe cirrhosis underwent complete laparoscopy were retrospectively analyzed from February 2010 to May 2012 in our hospital. Results All the 35 cases of laparoscopic resection of liver cancer were successful. There was no need of transfusion and no blood transfusion during operation. Among them, 21 cases had irregular hepatectomy and 14 cases had left hepatic resection. Surgery time (75 ~ 340) minutes, an average of (165.5 ± 117.3) minutes. The amount of bleeding was 15-300 ml, with an average of (168.6 ± 147.4) ml; no death; no postoperative complications such as liver bleeding, bile leakage, liver failure and abdominal abscess. The postoperative hospital stay was 5 to 10 days with an average of (9.2 ± 2.5) days. Conclusion Microwave-assisted coagulation combined with ultrasonic scalpel for complete laparoscopic resection of severe cirrhosis is a safe and effective minimally invasive treatment, which can significantly reduce the amount of bleeding during surgery and the incidence of postoperative complications.