检索结果-南通市图书馆

Laparoscopic liver resection for posterosuperior tumors using caudal approach and postural changes: A new technical approach

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2016年第47期22卷 10267-10274页

作者： zenichi morise Department of Surgery Fujita Health University School of Medicine

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.

关键词： Hepatectomy Laparoscopic 外科肝癌症姿势容易的位置

First quarter century of laparoscopic liver resection

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2017年第20期23卷 3581-3588页

作者： zenichi morise Go Wakabayashi Department of Surgery Fujita Health University School of Medicine Department of Surgery Center for Advanced Treatment of HBP DiseasesAgeo Central General Hospital

The beginnings of laparoscopic liver resection(LLR)were at the start of the 1990s,with the initial reports being published in 1991 and *** were followed by reports of left lateral sectionectomy 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 *** 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 *** 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 *** 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.

关键词： Hepatectomy Laparoscopic 外科肝癌症历史技术技术概念来临姿势模拟

Current status of laparoscopic repeat liver resection for hepatocellular carcinoma

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatoma Research 2020年第11期6卷 61-66页

作者： zenichi morise Department of Surgery Fujita Health University School of Medicine Okazaki Medical CenterOkazaki AICHI 444-0827Japan

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 *** conducted an international propensity score matching study of LRLR and open repeat LR for hepatocellular carcinoma with 1,582 patients from 42 world ***-score matched LRLR patients have smaller blood loss and longer operation time than open repeat LR *** 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 *** our institution,we experienced 34 LRLR and 12 cases of three times or more repeat LR until *** 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 ***,postoperative bile leakage and intraoperative bleeding causing conversion did happen in the cases with repeat extended exposure of Glissonian *** is feasible for selected ***,the procedure is under developing stage and further accumulation of experiences and evaluation are needed.

关键词： Laparoscopic liver resection hepatocellular carcinoma re-do surgery

Status and perspective of laparoscopic repeat liver resection

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Hepatology 2018年第7期10卷 479-484页

作者： zenichi morise Department of Surgery Fujita Health University School of Medicine

Liver resection(LR) is now actively applied to intrahepatic recurrence of liver metastases and hepatocellular carcinoma. Although indications of laparoscopic LR(LLR) have been expanded, there are increased risks of intraoperative complications and conversion in repeat LLR. Controversy still exists for the indication. There are 16 reports of small series to date. These studies generally reported that repeat LLR has better short-term outcomes than open(reduced bleedings, less or similar morbidity and shorter hospital stay) without compromising the long-term outcomes. The fact that complete adhesiolysis can be avoided in repeat LLR is also reported. In the comparison of previous procedures, it is reported that the operation time for repeat LLR was shorter for the patients previously treated with LLR than open. Furthermore, it is speculated that LLR for minor repeat LR of cirrhotic liver can be minimized the deterioration of liver function by LR. However, further experience and evaluation of anatomical resection or resections exposing major vessels as repeat LLR, especially after previous anatomical resection, are needed. There should be a chance to prolong the overall survival of the patients by using LLR as a powerful local therapy which can be applied repeatedly with minimal deterioration of liver function.

关键词： Hepatocellular carcinoma Laparoscopic liver resection Repeat surgery Metastasis

Surgery and chemotherapy for intrahepatic cholangiocarcinoma

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Hepatology 2010年第2期2卷 58-64页

作者： zenichi morise Atsushi Sugioka Takamasa Tokoro Yoshinao Tanahashi Yasuhiro Okabe Tadashi Kagawa Chinatsu Takeura Department of Surgery Fujita Health University School of Medicine 1-98 Dengakugakubo Kutsu- kake-cho Toyoake Aichi 470-1192 Japan

Cholangiocarcinoma, arising from bile duct epithelium, is categorized into intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC), including hilarcholangiocarcinoma. Recently, there has been a worldwide increase in the incidence and mortality from ICC. Complete surgical resection is the only approach to cure the patients with ICC. However, locoregional extension of these tumors is usually advanced with intrahepatic and lymph-node metastases at the time of diagnosis. Resectability rates are quite low and variable (18%-70%). The five-year survival rate after surgical resection was reported to be 20%-40%. Median survival time after ICC resection was 12-37.4 mo. Only a small number of ICC cases, accompanied with ECC, gall bladder carcinoma, and ampullary carcinoma, have been reported in the studies of chemotherapy due to the rarity of the disease. However, in some reports, significant anti-cancer effects were achieved with a response rate of up to 40% and a median survival ofone year. Although recurrence rate after hepatectomy is high for the patients with ICC, the residual liver and the lung are the main sites of recurrence after tentative curative surgical resection. Several patients in our study had a long-term survival with repeated surgery and chemotherapy. Repeated surgery, combined with new effective regimens of chemotherapy, could benef it the survival of ICC patients.

关键词： Intrahepatic cholangiocarcinoma Surgery Chemotherapy

Laparoscopic liver resection with lymph node dissection for gallbladder tumors suspected to be T1b/T2 carcinoma

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatoma Research 2017年第8期3卷 170-177页

作者： Masashi Isetani zenichi morise Akihiko Horiguchi Department of Surgery Fujita Health University Banbuntane Houtokukai HospitalNagoyaAichi 454-8509Japan Department of Surgery Fujita Health University School of MedicineToyoakeAichi 470-1192Japan

Aim: The short-term perioperative results of laparoscopic treatment of gallbladder (GB) carcinoma were evaluated to determine whether this technique can be a feasible treatment option. Methods: Ten patients with fundus/body GB tumors (GBTs) underwent laparoscopic liver resection (LLR) and lymph node dissection. Additionally, 124 patients underwent LLR for liver tumors. These 124 LLRs included 79 partial resections (PRs), 11 left lateral sectionectomies (LLSs), 25 anatomical resections (ARs), and 9 small ARs (SARs). The operation time (OT), intraoperative blood loss (BL), and postoperative length of hospital stay (LOS) were compared between the GBT and various LLR groups. Results: The median (range) OT in the GBT, PR, LLS, AR, and SAR groups was 298 (186-488), 245 (84-700), 328 (150-682), 458 (224-848), and 352 (274-696) min, respectively. The BL was 109 (10-500), 50 (0/uncountable-3,270), 100 (10-516), 375 (25-3,569), and 705 (35-1,920) mL, respectively. The LOS was 16 (8-105), 15 (5-254), 13 (11-52), 22 (8-44), and 15 (8-44) days, respectively. The OT and BL were significantly different between the GBT and AR groups. Conclusion:Laparoscopic surgery could be a good treatment option for GBTs suspected to be T1b/T2 GB carcinoma in the GB body/fundus without cystic duct invasion.

关键词： Gallbladder carcinoma laparoscopic surgery laparoscopic liver resection lymph node dissection

Pure laparoscopic hepatectomy as repeat surgery and repeat hepatectomy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第3期21卷 961-968页

作者： Masashi Isetani zenichi morise Norihiko Kawabe Hirokazu Tomishige Hidetoshi Nagata Jin Kawase Satoshi Arakawa Department of Surgery Fujita Health University School of MedicineBanbuntane Houtokukai HospitalAichiNagoya 454-8509Japan

AIM:To assess clinical outcomes of laparoscopic hepatectomy(LH) in patients with a history of upper abdominal surgery and repeat ***:This study compared the perioperative courses of patients receiving LH at our institution that had or had not previously undergone upper abdominal *** the 80 patients who underwent LH,22 had prior abdominal surgeries,including hepatectomy(n = 12),pancreatectomy(n = 3),cholecystectomy and common bile duct excision(n = 1),splenectomy(n = 1),total gastrectomy(n = 1),colectomy with the involvement of transverse colon(n = 3),and extended hysterectomy with extensive lymph-node dissection up to the upper abdomen(n = 1).Clinical indicators including operating time,blood loss,hospital stay,and morbidity were compared among the ***:Eighteen of the 22 patients who had undergone previous surgery had severe adhesions in the area around the ***,there were no conversions to laparotomy in this *** the 58 patients without a history of upper abdominal surgery,the median operative time was 301 min and blood loss was 150 m *** patients with upper abdominal surgical history or repeat hepatectomy,the operative times were 351 and 301 min,and blood loss was 100 and 50 m L,*** median postoperative stay was 17,13 and 12 d for patients with no history of upper abdominal surgery,patients with a history,and patients with repeat hepatectomy,*** were five cases with complications in the group with no surgical history,compared to only one case in the group with a prior *** were no statistically significant differences in the perioperative results between the groups with and without upper abdominal surgical history,or with repeat ***:LH is feasible and safe in patients with a history of upper abdominal surgery or repeat hepatectomy.

关键词： Chronic liver disease Laparoscopic hepatectomy Liv

Case report of the fourth laparoscopic liver resection and review of repeat laparoscopic resection for recurrent hepatocellular carcinoma in cirrhotic liver

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatoma Research 2016年第1期2卷 253-258页

作者： zenichi morise Masashi Isetani Norihiko Kawabe Hirokazu Tomishige Hidetoshi Nagata Satoshi Arakawa Masahiro Ikeda Kenshiro Kamio Department of Surgery Fujita Health University School of MedicineToyoakeAichi 470-1192Japan Department of Surgery Fujita Health University Banbuntane Houtokukai HospitalNagoyaAichi 454-8509Japan

A 73-year-old woman with liver cirrhosis caused by hepatitis C virus(HCV)underwent treatment of three hepatocellular carcinomas(HCCs)in liver segment 4,following three previous laparoscopic liver resections(LLRs)over 73 ***-enhanced computed tomography showed three 0.5-1.2 cm HCCs deep within the portal territories of subsegments 4a and *** patient underwent laparoscopic resection of 4a and 4b,with the preservation of the portal branch to 4c,after minimal adhesiolysis around segment *** operation lasted 284 min,there was 50 mL of intra-operative bleeding and her recovery was *** was well,had experienced no recurrence and was HCV-negative,after taking oral anti-HCV therapy,21 months *** is associated with fewer adhesions after surgery and requires less adhesiolysis,because the laparoscope and forceps can be used in the small spaces between *** present patient underwent four LLRs over 6 years without severe deterioration of liver functional *** is a useful localized therapy,which can be performed repeatedly and may prolong the survival of patients with multicentric metachronous HCCs.

关键词： Laparoscopic liver resection,repeat liver resection hepatocellular carcinoma liver cirrhosis anatomical liver resection subsegmentectomy

Recent advances in the surgical treatment of hepatocellular carcinoma

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2014年第39期20卷 14381-14392页

作者： zenichi morise Norihiko Kawabe Hirokazu Tomishige Hidetoshi Nagata Jin Kawase Satoshi Arakawa Rie Yoshida Masashi Isetani Department of Surgery Fujita Health University School of Medicine Banbuntane Houtokukai Hospital Nagoya 454-8509 Japan

Hepatocellular carcinoma(HCC) is the most common primary liver malignancy. The treatment of HCC is complex and complicated by the severity of associated chronic liver disease, the stage of HCC, and the clinical condition of the patient. Liver resection(LR) is one of the most efficient treatments for patients with HCC, with an expected 5-year survival of 38%-61% depending on the stage of the disease. Improved liver function assessment, increased understanding of segmental liver anatomy from advanced imaging studies, and surgical technical progress are important factors that have led to reduced mortality in patients with HCC. The indication for LR may be expanded due to emerging evidences from laparoscopic hepatectomies and combined treatments with newly developed chemotherapies. Liver transplantation(LT) is considered as an ideal treatment for removal of existing tumors and the injured/preneoplastic underlying liver tissue with impaired liver function and the risk of multicentric carcinogenesis that results from chronically injured liver. However, LT is restricted to patients with minimal risk of tumor recurrence under immunosuppression. The expansion of criteria for LT in HCC patients is still under trial and discussion. Limited availability of grafts, as well as the risk and the cost of transplantation have led to considerable interest in expansion of the donor pool, living donor-related transplantation, and combined treatment involving LR and LT. This highlight presents evidence concerning recent studies evaluating LR and LT in HCC patients. In addition, alternative therapies for the treatment of early stage tumors and the management of patients on transplant waiting lists are discussed.

关键词： Hepatocellular carcinoma Surgical treat-ment Hepat