전복강경간좌외측구역절제술이 표준 술식으로 정착되기까지의 경험

Gaining Experience before Establishing a Totally Laparoscopic Left Lateral Sectionectomy as a Standard Procedure

  • 이동식 (영남대학교 의과대학 외과학교실) ;
  • 최미란 (영남대학교 의과대학 외과학교실) ;
  • 김홍진 (영남대학교 의과대학 외과학교실) ;
  • 윤성수 (영남대학교 의과대학 외과학교실)
  • Lee, Dong-Shik (Department of Surgery, Yeungnam University Medical School) ;
  • Cui, Mei-Lan (Department of Surgery, Yeungnam University Medical School) ;
  • Kim, Hong-Jin (Department of Surgery, Yeungnam University Medical School) ;
  • Yun, Sung-Su (Department of Surgery, Yeungnam University Medical School)
  • 발행 : 2010.09.30

초록

Purpose: The aim of this study was to present our experience before establishing laparoscopic left lateral sectionectomy (LLLS) of the liver as a standard procedure, and to show efficacy of a totally LLLS compared to an open left lateral sectionectomy (OLLS). Methods: We retrospectively analyzed and compared clinical outcomes (operation time, blood loss, hospital stay, complication rate, etc) for 29 patients who underwent LLLS and 27 patients who underwent OLLS between January, 2002 and December, 2009. To see the learning curve for LLLS, we arbitrarily divided the LLLSs we did into an early group (ELLLS) and a late group (LLLLS) based on when they were operated on relative to case number 14. Results: Mean operative times for the ELLLS, LLLLS and OLLS groups were 269.7${\pm}$102.6, 210.0${\pm}$47.9 and 289.1${\pm}$72.8 minutes, respectively. Mean operative time was significantly shorter (p<0.05) in the LLLLS than the OLLS group. Mean intra-operative blood loss was also less in the LLLLS group than the OLLS group (80.00${\pm}$224.2 ml vs. 195.15${\pm}$405.4 ml). Post-operative hospital stay was shorter in the LLLLS group than the OLLS group (9.9${\pm}$4.0 versus 16.9${\pm}$9.1, p=0.071). Conclusion: The totally LLLS is a safe, feasible treatment option that can be a standard procedure with better outcomes in selected patients after an initial learning curve.

키워드

참고문헌

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