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活体肝移植术中使用手术放大镜与手术显微镜行肝动脉重建的疗效差异

杨健 谢炎 田大治 孙晓叶 蒋文涛

杨健, 谢炎, 田大治, 等. 活体肝移植术中使用手术放大镜与手术显微镜行肝动脉重建的疗效差异[J]. 器官移植, 2020, 11(5): 584-588. doi: 10.3969/j.issn.1674-7445.2020.05.009
引用本文: 杨健, 谢炎, 田大治, 等. 活体肝移植术中使用手术放大镜与手术显微镜行肝动脉重建的疗效差异[J]. 器官移植, 2020, 11(5): 584-588. doi: 10.3969/j.issn.1674-7445.2020.05.009
Yang Jian, Xie Yan, Tian Dazhi, et al. Difference of clinical efficacy between surgical magnifying glass and surgical microscope assisted hepatic artery reconstruction in living donor liver transplantation[J]. ORGAN TRANSPLANTATION, 2020, 11(5): 584-588. doi: 10.3969/j.issn.1674-7445.2020.05.009
Citation: Yang Jian, Xie Yan, Tian Dazhi, et al. Difference of clinical efficacy between surgical magnifying glass and surgical microscope assisted hepatic artery reconstruction in living donor liver transplantation[J]. ORGAN TRANSPLANTATION, 2020, 11(5): 584-588. doi: 10.3969/j.issn.1674-7445.2020.05.009

活体肝移植术中使用手术放大镜与手术显微镜行肝动脉重建的疗效差异

doi: 10.3969/j.issn.1674-7445.2020.05.009
基金项目: 

国家自然科学基金面上项目 81870444

天津市科委慢性病防治科技重大专项 17ZXMFSY00040

天津市第一中心医院春蕾计划 CL201801

天津市自然科学基金 19JCQNJC10300

详细信息
    作者简介:

    杨健, 男, 1987年生, 博士, 医师, 研究方向为器官移植, Email:yangjian0628@126.com

    通讯作者:

    蒋文涛, 男, 1974年生, 博士, 主任医师, 研究方向为器官移植, Email:447660280@qq.com

  • 中图分类号: R617

Difference of clinical efficacy between surgical magnifying glass and surgical microscope assisted hepatic artery reconstruction in living donor liver transplantation

More Information
  • 摘要:   目的  探讨手术放大镜与手术显微镜辅助方式下行活体肝移植(LDLT)术中肝动脉重建的疗效差异。  方法  回顾性分析272例LDLT供、受者的临床资料。根据肝动脉重建方式不同将受者分为放大镜组(189例)和显微镜组(83例), 评估两组受者手术时间、术中出血量、肝动脉重建位置、吻合口直径、术后并发症发生率、受者生存率等的差异。  结果  与显微镜组比较, 放大镜组的总手术时间更短、肝动脉重建时间更短、术中出血量更少, 差异均有统计学意义(均为P < 0.001)。放大镜组及显微镜组行肝动脉重建的最常见位置均为肝右动脉, 吻合口直径分别为(2.1±0.9)mm、(2.1±0.8)mm, 两组比较差异无统计学意义(P > 0.05)。放大镜组和显微镜组受者术后1、2、3年生存率分别为88%、86%、85%和89%、87%、86%, 差异均无统计学意义(均为P > 0.05)。两组受者术后并发症发生率比较, 差异亦均无统计学意义(均为P > 0.05)。  结论  LDLT术中手术放大镜下行肝动脉重建的效果及安全性并不低于手术显微镜, 且手术工作量和术中出血量更少。对于经验丰富的移植外科医师, 建议在放大镜辅助下行肝动脉重建操作。

     

  • 图  1  两组受者的术后生存曲线

    Figure  1.  Postoperative survival curves of recipients in two groups

    表  1  两组受者手术时间和出血量的比较

    Table  1.   Comparison of operation time and bleeding volume of recipients between two groups (x±s)

    组别 n 手术时间(h) 出血量(mL) 肝动脉重建时间(min)
    放大镜组 189 6.8±0.9 395±139 19±4
    显微镜组 83 7.3±1.1 462±151 25±6
    P < 0.001 < 0.001 < 0.001
    下载: 导出CSV

    表  2  两组受者肝动脉重建位置的比较

    Table  2.   Comparison of the location of hepatic artery reconstruction of recipients between two groups [n(%)]

    组别 n 肝固有动脉 肝右动脉 肝左动脉 其他
    放大镜组 189 46(24) 115(61) 12(6) 16(8)
    显微镜组 83 18(22) 54(65) 3(4) 8(10)
    P 0.753 0.459 0.562 0.818
    下载: 导出CSV
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出版历程
  • 收稿日期:  2020-05-18
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2020-09-15

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