Thoracoscopic hepatectomy for hepatic carcinoma in 3 cases / 中华普通外科杂志

ABSTRACT

Objective To study the safety,feasibility and efficacy of thoracoscopic hepatectomy for liver carcinoma. Methods Thoracoscopic hepatectomy was performed in 3 cases with single liver neoplasm from 2007 to 2011,including hepatocellular carcinoma ( HCC ) in one case and metastatic liver cancer in 2 cases.By preoperative imaging the tumor was located accurately to simulate the port position in operation.Patients were placed in a left lateral decubitus position,and 3 ports were inserted into the chest wall surrounding the tumor. Through the use of intra-operative thoracoscopic uhrasonography (IOTU),the diaphragm just above the tumor was opened.IOTU was performed on the liver surface and the resection line was marked.Throughout the course of parenchymal transection,IOTU was performed repeatedly to guide the resection line,and ensure the complete removal of the tumor.After meticulous hemostasis of the resection surface,the diaphragm was closed. A thoracic drain was left. Results Thoracoscopic hepatectomy succeeded in all 3 cases,the median total operating time was 150 min (110 -210 min),and the medianblood loss was 297 ml (130 -600 ml). Patients recovered quickly and had no major post-operative complications.During 9 to 42 months' follow-up,one patients died of other cause,no relapse of the diseases was found. Conclusions Thoracoscopic hepatectomy is a safe and feasible operation in selected patients and has advantages in post-operative morbidity and in hospital time.