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目的探讨转移性肝癌的腹腔镜肝切除术经验。方法对1997年至2004年度布里斯班医院所进行的所有肝切除术患者进行回顾性研究。结果有84例患者进行了腹腔镜肝切除,其中33例(39%)为恶性肿瘤。33例中28例为转移性,其中22例为结直肠癌转移。13例患者进行左肝外侧叶切除,9例患者进行了右半肝切除,其余6例行肝段或不规则切除。67%失去随访,追踪随访12例患者2年存活率和无瘤生存率为75%和67%。结论在高度选择过的恶性肿瘤患者中行腹腔镜肝切除术是可行的。但要求术者有丰富的开腹肝切除术经验和腹腔镜操作技能。
Objective To investigate the experience of laparoscopic hepatectomy for metastatic liver cancer. Methods A retrospective study was performed on all patients undergoing liver resection at the Brisbane Hospital from 1997 to 2004. Results A total of 84 patients underwent laparoscopic liver resection, of which 33 (39%) were malignant. Twenty-eight of the 33 cases were metastatic, of which 22 were metastatic to colorectal cancer. Thirteen patients underwent lateral lobectomy of the left liver, nine patients underwent right hemihepatectomy, and the remaining six underwent hepatic segmental or irregular resections. Sixty-seven percent of patients lost follow-up, and follow-up of 12 patients showed 2-year and 75% disease-free survival rates of 75% and 67%, respectively. Conclusions Laparoscopic liver resection is feasible in highly selected patients with malignant tumors. However, those who require surgery have a wealth of experience in open hepatectomy and laparoscopic skills.