我国腹腔镜下肝切除术已达国际先进水平

2016-07-11 MedSci MedSci原创

7月8日~9日,复旦大学附属肿瘤医院肝外科专家论坛在上海召开。本次会议的执行主席、复旦大学附属肿瘤医院肝外科王鲁教授介绍,会议由复旦大学附属肿瘤医院主办,上海市抗癌协会和杂志社承办。会议以外科诊疗为主题,并邀请汤钊猷院士、陈孝平教授、李强教授、蔡秀军教授、蔡三军教授等国内知名专家围绕“原发性肝癌治疗”、“结直肠癌肝转移治疗”、”腹腔镜肝切除”等当前肝脏肿瘤外科热点与焦点问题进行研讨。区别于既往以肿


78~9日,复旦大学附属肿瘤医院肝外科专家论坛在上海召开。本次会议的执行主席、复旦大学附属肿瘤医院肝外科王鲁教授介绍,会议由复旦大学附属肿瘤医院主办,上海市抗癌协会和杂志社承办。会议以外科诊疗为主题,并邀请汤钊猷院士、陈孝平教授、李强教授、蔡秀军教授、蔡三军教授等国内知名专家围绕“原发性肝癌治疗结直肠癌肝转移治疗”、腹腔镜肝切除等当前肝脏肿瘤外科热点与焦点问题进行研讨。区别于既往以肿瘤学方面和综合性为侧重点的外科论坛,本次会议将更加侧重实用性,会议将采用双向互动的模式进行病例讨论。梅斯医学作为特约媒体参加了此次大会。

肝癌是发生于肝脏的恶性肿瘤,包括原发性肝癌、转移性肝癌,人们日常说的肝癌多是指原发性肝癌。原发性肝癌是临床最常见的恶性肿瘤之一,全球发病率逐年增长,已超过62.6/年,居于恶性肿瘤的第五位,死亡接近60/年,位居肿瘤相关死亡的第三位。目前,我国发病人数约占全球的55%,在我国排名前十肿瘤病种中,肝癌发病率排名第四、死亡率排名第二。形成肝癌的因素主要有:病毒性肝炎(在我国主要是乙型肝炎)、黄曲霉菌毒素(粮食霉变)、水源污染(蓝绿藻污染的水源)、化学致癌物质(腌制食品)、其他因素(吸烟、长期饮酒等)。

腹腔镜下肝切除术具有创口小、心肺功能影响小、感染几率低、康复快等优势,在“精准肝切除理念引导下,肝外科领域已经广泛应用。王鲁重点介绍了腹腔镜肝切除的治疗情况,他指出在一项由400多名医生参与的调查中,约有5%的医生可以一年内完成超过200例腹腔镜肝切除手术。而在复旦大学附属肿瘤医院每年完成的约700例肝脏手术中,腹腔镜占比接近40%,即一年能完成接近300例腹腔镜肝切除术。相较于国际同行,在通过应用腹腔镜肝切除治疗原发性肝癌和结直肠癌肝转移的比例中,约有20%的大范围肝切除能够通过腹腔镜完成,局部肝切除可达到30%。国内规模较大的肝胆治疗中心基本上都能达到该水平,甚至部分医院能达到更高水准。他强调从技术上讲,肝脏外科的前沿技术不单单是指手术本身,还包括术前准备、术后处理、围手术期处理等。而随着技术和设备的发展,机器人技术的成熟,腹腔镜技术一定能再上一个新台阶。

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    2017-02-10 changfy
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随着腹腔镜技术的兴起和流行,在手术方式的选择上,很多人都认为腹腔镜手术比开腹更好。不过对于直肠癌切除术,因为直肠的解剖结构的约束,腹腔镜手术行癌肿切除时可能会更加受到限制。研究者在2010年3月-2014年11月进行了一项随机、非劣性、3期研究(ALaCaRT) ,包括澳大利亚和新西兰24个机构的26名外科医生,以及475名T1-T3期直肠腺癌患者(距离肛门边缘小于15厘米)。共有237名患者进行

BMC Cancer:早期宫颈癌根治性子宫切除:腹腔镜vs.开腹?

研究者检索了PubMed、MEDLINE、EMBASE、the Cochrane Library和BIOSIS数据库上关于早期宫颈癌患者腹腔镜下根治性子宫切除(LRH)和开腹根治性子宫切除(RH)比较的研究,比较了两种不同术式的围手术期结局、肿瘤清除情况、并发症和长期结局。最终纳入了12项比较LRH(n = 754)和RH(n = 785)的研究。分析数据显示,与RH相比,LRH可显著减少术中出血

JAMA:直肠癌患者:腹腔镜手术vs开腹手术

目前对经腹腔镜行直肠癌切除术的有效性评价不一,尤其是晚期直肠癌。研究者进行了一项多中心双盲的随机对照试验,欲探究对于直肠癌患者行切除术,究竟是选择腹腔镜好,还是开腹手术更优,以大体标本和切除后组织结果作为评判。该研究于2008.10-2013.09在美国和加拿大的35个中心进行,共纳入486名临床分期为II、III期、距离肛门外源12cm以内的直肠癌患者,完成新辅助化疗后,随机分为腹腔镜组(n=2