{"title":"腹腔镜肝切除术第 8 节段腹侧与背侧区域的比较。","authors":"Kentaro Oji, Takeshi Urade, Masahiro Kido, Shohei Komatsu, Hidetoshi Gon, Nobuaki Yamasaki, Kenji Fukushima, Shinichi So, Toshihiko Yoshida, Keisuke Arai, Masayuki Akita, Jun Ishida, Yoshihide Nanno, Daisuke Tsugawa, Sadaki Asari, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto","doi":"10.1007/s00423-024-03435-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The technical difficulties of laparoscopic liver resection (LLR) are greatly associated with the location of liver tumors. Since segment 8 (S8) contains a wide area, the difficulty of LLR for S8 tumors may vary depending on the location within the segment, such as the ventral (S8v) and dorsal (S8d) area, but the difference is unclear.</p><p><strong>Methods: </strong>We retrospectively investigated 30 patients who underwent primary laparoscopic partial liver resection for liver tumors in S8 at Kobe University Hospital between January 2018 and June 2023.</p><p><strong>Results: </strong>Thirteen and 17 patients underwent LLR for S8v and S8d, respectively. The operation time was significantly longer (S8v 203[135-259] vs. S8d 261[186-415] min, P = 0.002) and the amount of blood loss was significantly higher (10[10-150] vs. 10[10-200] mL, P = 0.034) in the S8d group than in the S8v group. No significant differences were observed in postoperative complications or postoperative length of hospital stay. Additionally, intraoperative findings revealed that the rate at which the case performed partial liver mobilization in the S8d group was higher (2[15.4%] vs. 8[47.1%], P = 0.060) and the median parenchymal transection time of the S8d group was longer (102[27-148] vs. 129[37-175] min, P = 0.097) than those in the S8v group, but there were no significant differences.</p><p><strong>Conclusion: </strong>The safety of LLR for the S8d was comparable to that of LLR for S8v, although LLR for S8d resulted in longer operative time and more blood loss.</p><p><strong>The trial registration number: </strong>B230165 (approved at December 26, 2023).</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of laparoscopic liver resection for the ventral versus the dorsal areas of segment 8.\",\"authors\":\"Kentaro Oji, Takeshi Urade, Masahiro Kido, Shohei Komatsu, Hidetoshi Gon, Nobuaki Yamasaki, Kenji Fukushima, Shinichi So, Toshihiko Yoshida, Keisuke Arai, Masayuki Akita, Jun Ishida, Yoshihide Nanno, Daisuke Tsugawa, Sadaki Asari, Hiroaki Yanagimoto, Hirochika Toyama, Takumi Fukumoto\",\"doi\":\"10.1007/s00423-024-03435-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The technical difficulties of laparoscopic liver resection (LLR) are greatly associated with the location of liver tumors. Since segment 8 (S8) contains a wide area, the difficulty of LLR for S8 tumors may vary depending on the location within the segment, such as the ventral (S8v) and dorsal (S8d) area, but the difference is unclear.</p><p><strong>Methods: </strong>We retrospectively investigated 30 patients who underwent primary laparoscopic partial liver resection for liver tumors in S8 at Kobe University Hospital between January 2018 and June 2023.</p><p><strong>Results: </strong>Thirteen and 17 patients underwent LLR for S8v and S8d, respectively. The operation time was significantly longer (S8v 203[135-259] vs. S8d 261[186-415] min, P = 0.002) and the amount of blood loss was significantly higher (10[10-150] vs. 10[10-200] mL, P = 0.034) in the S8d group than in the S8v group. No significant differences were observed in postoperative complications or postoperative length of hospital stay. Additionally, intraoperative findings revealed that the rate at which the case performed partial liver mobilization in the S8d group was higher (2[15.4%] vs. 8[47.1%], P = 0.060) and the median parenchymal transection time of the S8d group was longer (102[27-148] vs. 129[37-175] min, P = 0.097) than those in the S8v group, but there were no significant differences.</p><p><strong>Conclusion: </strong>The safety of LLR for the S8d was comparable to that of LLR for S8v, although LLR for S8d resulted in longer operative time and more blood loss.</p><p><strong>The trial registration number: </strong>B230165 (approved at December 26, 2023).</p>\",\"PeriodicalId\":17983,\"journal\":{\"name\":\"Langenbeck's Archives of Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-08-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Langenbeck's Archives of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00423-024-03435-4\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Langenbeck's Archives of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00423-024-03435-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
目的:腹腔镜肝脏切除术(LLR)的技术难度与肝脏肿瘤的位置有很大关系。由于第 8 节段(S8)包含的区域很广,S8 肿瘤的腹腔镜肝切除术难度可能会因腹侧(S8v)和背侧(S8d)等节段内的位置不同而有所差异,但这种差异尚不明确:我们回顾性调查了2018年1月至2023年6月期间在神户大学医院接受原发性腹腔镜肝部分切除术治疗S8肝肿瘤的30例患者:分别有13名和17名患者因S8v和S8d接受了腹腔镜肝部分切除术。S8d 组的手术时间明显长于 S8v 组(S8v 203[135-259] 分钟 vs. S8d 261[186-415] 分钟,P = 0.002),失血量明显高于 S8v 组(10[10-150] mL vs. 10[10-200] mL,P = 0.034)。术后并发症和术后住院时间没有明显差异。此外,术中结果显示,S8d 组病例进行部分肝脏移动的比率更高(2[15.4%] vs. 8[47.1%],P = 0.060),S8d 组的中位实质横断时间比 S8v 组更长(102[27-148] vs. 129[37-175] min,P = 0.097),但无显著差异:结论:S8d LLR 的安全性与 S8v LLR 相当,但 S8d LLR 的手术时间更长,失血量更多。
Comparison of laparoscopic liver resection for the ventral versus the dorsal areas of segment 8.
Purpose: The technical difficulties of laparoscopic liver resection (LLR) are greatly associated with the location of liver tumors. Since segment 8 (S8) contains a wide area, the difficulty of LLR for S8 tumors may vary depending on the location within the segment, such as the ventral (S8v) and dorsal (S8d) area, but the difference is unclear.
Methods: We retrospectively investigated 30 patients who underwent primary laparoscopic partial liver resection for liver tumors in S8 at Kobe University Hospital between January 2018 and June 2023.
Results: Thirteen and 17 patients underwent LLR for S8v and S8d, respectively. The operation time was significantly longer (S8v 203[135-259] vs. S8d 261[186-415] min, P = 0.002) and the amount of blood loss was significantly higher (10[10-150] vs. 10[10-200] mL, P = 0.034) in the S8d group than in the S8v group. No significant differences were observed in postoperative complications or postoperative length of hospital stay. Additionally, intraoperative findings revealed that the rate at which the case performed partial liver mobilization in the S8d group was higher (2[15.4%] vs. 8[47.1%], P = 0.060) and the median parenchymal transection time of the S8d group was longer (102[27-148] vs. 129[37-175] min, P = 0.097) than those in the S8v group, but there were no significant differences.
Conclusion: The safety of LLR for the S8d was comparable to that of LLR for S8v, although LLR for S8d resulted in longer operative time and more blood loss.
The trial registration number: B230165 (approved at December 26, 2023).
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.