Lessons learned from 100 initial cases of laparoscopic liver surgery
이미리, 김영훈, 노영훈, 오성용, 조진한, 이종훈, 이성욱, 노명환, 정진숙, 한상영, 정갑중,
소속 상세정보
이미리 ( Lee Mi-Ri )
Dong-A University College of Medicine Department of Surgery
김영훈 ( Kim Young-Hoon )
Dong-A University College of Medicine Department of Surgery
노영훈 ( Roh Young-Hoon )
Dong-A University College of Medicine Department of Surgery
오성용 ( Oh Sung-Yong )
Dong-A University College of Medicine Department of Internal Medicine
조진한 ( Cho Jin-Han )
Dong-A University College of Medicine Department of Radiology
이종훈 ( Lee Jong-Hoon )
Dong-A University College of Medicine Department of Internal Medicine
이성욱 ( Lee Sung-Wook )
Dong-A University College of Medicine Department of Internal Medicine
노명환 ( Roh Myung-Hwan )
Dong-A University College of Medicine Department of Internal Medicine
정진숙 ( Jeong Jin-Sook )
Dong-A University College of Medicine Department of Pathology
한상영 ( Han Sang-Young )
Dong-A University College of Medicine Department of Internal Medicine
정갑중 ( Jung Ghap-Joong )
Dong-A University College of Medicine Department of Surgery
KMID : 0371320110800050334
Abstract
Purpose: Laparoscopic liver resection (LLR) is now widely accepted and is being increasingly performed. The present study describes our experience with LLR at a single center over an eight-year period.
Methods: This retrospective study enrolled 100 patients between October 2002 and February 2010. Forty-six benign lesions and 54 malignant lesions were included. The LLR performed included 58 pure laparoscopy procedures, 18 hand-assisted laparoscopy procedures and 24 hybrid technique procedures.
Results: The mean age of the patients was 57 years; among these patients, 31 were over 65 years of age. The mean operation time was 220 minutes. The overall morbidity was 11% and the mortality was zero. Among the 20 patients with simple hepatic cysts, 50% unexpectedly recurred. Among the 41 patients with hepatocellular carcinoma, 21 patients (51%) underwent preoperative radiofrequency ablation therapy or transarterial chemoembolization. During parenchymal-transection, 11 received blood transfusion. The width of the resection margins was under 0.5 cm in 11 cases (27%); 0.5 to 1 cm in 22 cases (54%) and over 1 cm in eight cases (12%). There was no port site seeding, but argon beam coagulation-induced tumor dissemination was observed in two cases. The overall two-year survival rate was 75%.
Conclusion: This study suggests that the applications for LLR can be gradually expanded when assuring that the safety and curability of LLR are equivalent to that of open liver resection.
키워드
Laparoscopic liver resection; Hepatic cyst; Hapatocellular carcinoma; Resection margin
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