Left-lateral decubitus jackknife position for laparoscopic resection of right posterior liver tumors: A safe and effective approach.

IF 2.1 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2025-01-04 DOI:10.1007/s00423-024-03595-3

Xiaohan Kong, Zheyu Niu, Heng Wang, Meng Liu, Chaoqun Ma, Jun Lu, Xu Zhou, Huaqiang Zhu

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引用次数: 0

Abstract

Purpose: To compare outcomes of LLR in VI/VII of the liver in Left-lateral Decubitus Jackknife Position (LDJP) and traditional Supine Position (SP). We used propensity score matching (PSM) to analyze clinical outcomes.

Patients & methods: This study retrospectively analyzed patients undergoing LLR for liver tumors in segments VI and/or VII at Shandong Provincial Hospital from 2018 to 2023. A total of 218 cases were included (LDJP, n = 94; SP, n = 124). Matched 1:1 PSM groups were created and clinical indicators compared between groups.

Results: 218 LLR patients, 94 LDJP and 124 supine. After 1:1 PSM, each group had 62 patients. No significant differences in clinical or laboratory parameters. All surgeries were successful, 1 LDJP conversion to open resection and 4 SP conversions (P = 0.375). LDJP average surgery duration: 220.6 ± 29.9 min, supine position: 262.6 ± 35.6 min (P < 0.001). LDJP perioperative blood loss: 169.0 ± 74.4 mL, supine position: 231.6 ± 84.6 mL (P < 0.001). Four LDJP patients required intraoperative blood transfusion compared to 16 supine position patients (P = 0.012). All cases had negative margins postoperatively. No significant differences in postoperative complications (8 LDJP vs 9 supine, P = 0.675) or length of hospital stay (25 LDJP vs 26 supine, ≥ 7 days) (P = 1.000).

Conclusion: Laparoscopic partial hepatectomy in LDJP for hepatic VI/VII tumor safe and feasible. Reduces operative time, blood loss, transfusion requirement, improving outcomes.

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左侧卧刀位在腹腔镜下切除右后肝肿瘤是一种安全有效的方法。

目的：比较左侧卧刀位（LDJP）和传统仰卧位（SP）下肝脏VI/VII部位LLR的预后。我们使用倾向评分匹配（PSM）来分析临床结果。患者和方法：本研究回顾性分析了2018年至2023年山东省立医院第六和/或第七节肝肿瘤行LLR的患者。共纳入218例(LDJP, n = 94；SP, n = 124)。建立1:1匹配的PSM组，比较各组临床指标。结果：LLR 218例，LDJP 94例，仰卧124例。1:1 PSM后，每组62例。临床或实验室参数无显著差异。所有手术均成功，1例LDJP转开切，4例SP转开切（P = 0.375）。LDJP平均手术时间：220.6±29.9 min，仰卧位：262.6±35.6 min (P)结论：腹腔镜LDJP部分肝切除术治疗肝VI/VII肿瘤安全可行。减少手术时间、出血量、输血需求，改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.