肝脏后上段:由一名外科医生实施的开放手术与微创手术的短期疗效比较

Livers Pub Date : 2023-11-16 DOI:10.3390/livers3040044
M. Giuffrida, M. Iaria, R. Dalla Valle
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引用次数: 0

摘要

腹腔镜肝后段切除术在技术上具有挑战性。这是一项单中心、单外科医生的回顾性研究。本研究旨在调查帕尔马大学医院(Parma University Hospital)由一名外科医生实施的腹腔镜肝后段切除术(LLR)和开腹肝后段切除术(OLR)的短期疗效。患者被分为第1组(OLR)和第2组(LLR),并根据外科医生的经验在两个不同的时间段(2010-2015年和2016-2021年)进行分层。研究共纳入了 112 名患者。75.3%的OLR在第一阶段进行,而70.2%的LLR在第二阶段(2016-2021年)进行。与 LLR 组相比,OLR 组的岩手评分明显更高(P < 0.001)。大多数高级 LLR(77%)和专家 LLR(100%)是在第二阶段进行的。LLR 组的 LOS 比 OLR 组短(P 0.05)。肝硬化和多发性病变是导致严重术后并发症的危险因素。随着外科医生专业知识的不断提高,以及尖端技术和创新手术技巧的应用,PSS-LLR 已经变得更加安全和有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Posterosuperior Segments of the Liver: Comparison of Short-Term Outcomes between Open and Minimally Invasive Surgery Performed by a Single Surgeon
Laparoscopic posterosuperior liver segment resection is considered technically challenging. This is a retrospective single-center single-surgeon study. The aim of the present study is to investigate the short-term outcomes in a single institution between laparoscopic (LLR) and open (OLR) posterosuperior liver segments (PSSs) resections performed by a single surgeon at Parma University Hospital. The patients were divided into Group 1 (OLR) and Group 2 (LLR) and stratified in two different time settings according to the experience of the surgeon (2010–2015 and 2016–2021). A total 112 patients were included in the study. The 75.3% of OLR were performed in the first period, while 70.2% of LLR were carried out during the second period (2016–2021). The Iwate score was significantly (p < 0.001) higher in OLR group compared to the LLR group. Most of the advanced (77%) and expert (100%) LLRs were performed during the second period. LOS was shorter in LLR group comparing to OLR group (p < 0.001). The postoperative morbidity rate was similar in both groups (p > 0.05). The presence of liver cirrhosis and multiple lesions were identified as risk factors for severe postoperative complications. PSS-LLR has become much safer and more effective due to increasing surgeon’s expertise along with the implementation of cutting-edge technology and innovative surgical techniques.
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