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| 1 | Laparoscopic liver resection for posterosuperior tumors using caudal approach and postural changes: A new technical approach显示文摘Laparoscopic liver resection(LLR) for tumors in the posterosuperior liver [segment(S) 7 and deep S6] is a challenging clinical procedure. This area is located in the bottom of the small subphrenic space(rib cage), with the large and heavy right liver on it when the patient is in the supine position. Thus, LLR of this area is technically demanding because of the handling of the right liver which is necessary to obtain a fine surgical view, secure hemostasis and conduct the resection so as to achieve an appropriate surgical margin in the cage. Handling of the right liver may be performed by the hand-assisted approach, robotic liver resection or by using spacers, such as a sterile glove pouch. In addition, the operative field of posterosuperior resection is in the deep bottom area of the subphrenic cage, with the liver S6 obstructing the laparoscopic caudal view of lesions. The use of intercostal ports facilitates the direct lateral approach into the cage and to the target area, with the combination of mobilization of the liver. Postural changes during the LLR procedure have also been reported to facilitate the LLR for this area, such as left lateral positioning for posterior sectionectomy and semi-prone positioning for tumors in the posterosuperior segments. In our hospital, LLR procedures for posterosuperior tumors are performed via the caudal approach with postural changes. The left lateral position is used for posterior sectionectomy and the semi-prone position is used for S7 segmentectomy and partial resections of S7 and deep S6 without combined intercostal ports insertion. Although the movement of instruments is restricted in the caudal approach, compared to the lateral approach, port placement in the para-vertebra area makes the manipulation feasible and stable, with minimum damage to the environment around the liver. | Zenichi Morise | 2016 | World Journal of Gastroenterology2016，22，47： | 20 |
| 2 | First quarter century of laparoscopic liver resection显示文摘The beginnings of laparoscopic liver resection(LLR)were at the start of the 1990s,with the initial reports being published in 1991 and 1992.These were followed by reports of left lateral sectionectomy in 1996.In the years following,the procedures of LLR were expanded to hemi-hepatectomy,sectionectomy,segmentectomy and partial resection of posterosuperior segments,as well as the parenchymal preserving limited anatomical resection and modified anatomical(extended and/or combining limited)resection procedures.This expanded range of LLR procedures,mimicking the expansion of open liver resection in the past,was related to advances in both technology(instrumentation)and technical skill with conceptual changes.During this period of remarkable development,two international consensus conferences were held(2008 in Louisville,KY,United States,and 2014 in Morioka,Japan),providing up-to-date summarizations of the status and perspective of LLR.The advantages of LLR have become clear,and include reduced intraoperative bleeding,shorter hospital stay,and-especially for cirrhotic patients-lower incidence of complications(e.g.,postoperative ascites and liver failure).In this paper,we review and discuss the developments of LLR in operative procedures(extent and style of liver resections)during the first quarter century since its inception,from the aspect of relationships with technological/technical developments with conceptual changes. | Zenichi Morise Go Wakabayashi | 2017 | World Journal of Gastroenterology2017，23，20： | 16 |
| 3 | 腹腔镜下右半肝血流阻断的肝右后叶切除术(附16例报告)显示文摘目的:探讨腹腔镜下采用右半肝血流阻断行肝右后叶切除术的可行性。方法:2016年1月至2016年12月为16例肝右后叶肿瘤患者行完全腹腔镜肝右后叶切除术,术中采用血流阻断。结果:16例手术均获成功,无一例中转开腹,手术时间150~290 min,平均(196.2±12.5)min;右半肝阻断时间20~40 min,平均(26.5±1.2)min;术中出血量150~400 ml,平均(255.0±8.3)ml。术后无出血、肝功能衰竭、胆漏、感染、死亡等严重并发症发生。术后住院5~12 d,平均(6.6±0.5)d。结论:在熟练掌握腹腔镜肝切除操作要点的前提下,采用右半肝血流阻断技术行腹腔镜肝右后叶切除术治疗肝肿瘤是安全、可行的。 | 郑志鹏 何军明 钟小生 刁竞芳 彭建新 莫嘉强 叶青 沈展涛 | 2017 | 腹腔镜外科杂志2017，22，11： | 3 |
| 4 | 腹腔镜肝切除治疗肝细胞癌现状及挑战显示文摘1987年腹腔镜技术应用于肝胆外科手术,并成功开展首例腹腔镜胆囊切除术[1]。1991年Reich等[2]实施了世界上第一例腹腔镜肝脏局部切除。之后腹腔镜手术安全性及可行性得到了验证,其中Witowski等[3]通过Meta分析纳入了5100例病例,发现腹腔镜肝切除(laparoscopic hepatectomy,LH)术后并发症发生率较开腹肝切除术(open hepatectomy,OH)明显降低。由于受腔镜设备及能量器械限制,腹腔镜最早仅应用于肝囊肿开窗、肝血管瘤局部切除等简单手术。 | 罗发 陈焕伟 | 2022 | 中华肝脏外科手术学电子杂志2022，11，2： | 0 |
| 5 | 肝悬吊术在腹腔镜肝切除术中的应用研究进展显示文摘肝悬吊术(LHM)是指在肝切除术中利用一根胶带从肝后潜在间隙穿出环绕肝脏将其提拉。自该技术问世以来,其主要运用于开放式肝切除术中。近年来,腹腔镜肝切除(LLR)已成为一种标准的手术方式,在LLR中使用LHM可以提供良好的手术视野,同时可以保护肝短静脉、减少术中出血、缩短手术时间、利于患者肝切除术后肝功能恢复、提高患者术后生存率。 | 唐任超 赵振荣 王康宣(综述) 汪建初(审校) | 2023 | 海南医学2023，34，6： | 0 |
| 6 | Current status of laparoscopic repeat liver resection for hepatocellular carcinoma显示文摘Although liver resection(LR)is often adopted to recurrent hepatocellular carcinomas,risks of complications and conversion reportedly increase in laparoscopic repeat LR(LRLR).The indication is not agreed upon even with the recent advances of laparoscopic LR.We conducted an international propensity score matching study of LRLR and open repeat LR for hepatocellular carcinoma with 1,582 patients from 42 world centers.Propensity-score matched LRLR patients have smaller blood loss and longer operation time than open repeat LR patients.Median overall survival time was 8.94 years in open and 12.55 years in LRLR;although the difference was not significant,the P-value was 0.0855 and the better curve of LRLR is clearly separated from that of open.In our institution,we experienced 34 LRLR and 12 cases of three times or more repeat LR until 2019.There are no significant differences in operation time,blood loss,hospital stay,conversion,and morbidity rates among first,second,and third or higher laparoscopic LR,which is different from the open situation.However,postoperative bile leakage and intraoperative bleeding causing conversion did happen in the cases with repeat extended exposure of Glissonian pedicle.LRLR is feasible for selected patients.However,the procedure is under developing stage and further accumulation of experiences and evaluation are needed. | Zenichi Morise | 2020 | Hepatoma Research2020，6，11： | 0 |
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