【摘要】 目的:研究三维重建技术对不同手术难度腹腔镜肝切除术的影响，为三维重建在复杂与非复杂腹腔镜肝切除围术期的应用提供依据。方法:回顾分析2016年6月至2021年11月因肝癌行腹腔镜肝切除术的70例患者的临床资料。结果:各组患者一般资料差异无统计学意义(P>0.05)。复杂重建组手术时间[(403.13±89.99)min vs.(479.50±115.39)min,P=0.030]、术中出血量[150(85～380)mL vs. 325(200～725)mL,P=0.014]、术中输血例数[5(31.3%) vs. 10(71.4%),P=0.028]、实际切除>预计切除[3(18.80%) vs. 9(64.3%),P=0.011]、中转开腹[3(18.80%) vs. 7(50.00%),P=0.029]、术后住院时间[(10.13±2.22)d vs.(14.43±2.98)d,P=0.010]优于复杂对照组，差异有统计学意义。非复杂重建组手术时间短于非复杂对照组，差异有统计学意义(P<0.05),出血量、中转开腹率、实际切除>预切切除、术后住院时间及输血率等差异无统计学意义(P>0.05)。术后第1天、第3天、第5天，三维重建组与对照组ALT、AST差异无统计学意义(P>0.05)。结论:术前三维重建对高难度的腹腔镜肝切除术具有显著的指导意义，但对非复杂腹腔镜肝切除术的影响尚不明确。更多还原

【Abstract】 Objective:Hepatectomy is an effective method to treat hepatic carcinoma and prolong survival.This paper aims to further study the influence of three-dimensional(3 D) reconstruction technology on various indicators of laparoscopic hepatectomy with different surgical difficulties, and to provide evidence for the application value of 3 D reconstruction in the perioperative period of complex and uncomplex laparoscopic hepatectomy.Methods:This study retrospectively analyzed the clinical data of 70 patients who underwent laparoscopic hepatectomy for liver cancer from Jun.2016 to Nov.2021.Results:There was no significant difference in general data between groups.In the complex reconstruction group, the operative time [(403.13±89.99)min vs.(479.50±115.39)min, P=0.030],the intraoperative blood loss [150(85～380)mL vs. 325(200～725)mL,P=0.014],intraoperative blood transfusion [5(31.3%) vs. 10(71.4%),P=0.028],actual resection>estimated resection [3(18.80%) vs. 9(64.3%),P=0.011],conversion to laparotomy [3(18.80%) vs. 7(50.00%),P=0.029],postoperative hospital stay[(10.13±2.22)d vs.(14.43±2.98)d, P=0.010] were better than those in complex control group, and the differences were statistically significant(P<0.05).The operative time of the uncomplicated reconstruction group was shorter than that of the uncomplicated control group, the difference was statistically significant(P<0.05);the intraoperative blood loss, rate of conversion to laparotomy, actual resection>estimated resection, postoperative hospital stay and blood transfusion rate were not statistically significantly different(P>0.05).Comparison of ALT and AST on the 1 st, 3 rd and 5 th day after surgery showed that there was no significant difference between the 3 D reconstruction group and the control group(P>0.05).Conclusions:Preoperative 3 D reconstruction has significant guiding significance for highly difficult laparoscopic hepatectomy, but its significance for uncomplicated laparoscopic hepatectomy remains to be discussed.更多还原