マイクロ波凝固装置を用いた肝切除術―特に肝門阻血との併用について―

• 宮川 雄輔

  国立療養所中信松本病院消火器外科

• 原田 晴久

  国立療養所中信松本病院消火器外科

• 中田 岳成

  国立療養所中信松本病院消火器外科

• 岩崎 明実

  国立療養所中信松本病院消火器外科

• 福井 大祐

  国立療養所中信松本病院消火器外科

• 西牧 敬二

  国立療養所中信松本病院消火器外科

• 前島 信也

  国立療養所中信松本病院消化器内科

• 小林 正和

  国立療養所中信松本病院消化器内科

• 小林 正典

  国立療養所中信松本病院消化器内科

• 袖山 健

  国立療養所中信松本病院消化器内科

• 今井 豊

  国立療養所中信松本病院放射線科

書誌事項

タイトル別名

• Hepatectomy with microwave tissue coagulator: with special reference to combination of hemi-or total hepatic vascular occulusion

抄録

We investigated the advantage to hepatectomy with combination of microwave tissue coagulator (MTC) and hepatic vascular occulusion. Fourty one consecutive patients undergoing hepatic resection by our method were evaluated with references to comparison of reported hepatectomized cases using MTC without hepatic vascular clamp. We performed microwave coagulation only along the intended liver surface resection line and no more, then urtrasonically guided liver resection initiated along with coagulated line by forceps frature method with intermittent vasucular occulusion. The efficacy of MTC in hepatectomy, as many authors reported, was reduction in blood loss during operation without vasucular clamp i.e. warm ischemia of the liver which regarded as contraindicates to dameged liver. This 41 consecutive liver resections consisted of partial (Hr0 : 13), subsegmental (Hr1 : 13), segmental (Hr1 : 8), lobar (Hr2 : 1), extended lobar (Hr2 + : 1). In this study, the cases of postoprerative intrperitoneal infection, bile lekage, hemorrhage, was one respectively (2.4%) and ascites were 2 cases (4.9%), pleural effusion were 3 cases (7.3%). The average amount of blood loss was 763 ± 110 ml and average volume of resected liver was 194 ± 209g. The post operative laboratory data related to liver function changed within accepatable range reasonable for operative magnitude. Intraperative blood loss, postoperative complications' rates, postoperarive clinical courses were all not only diferent with using MTC without hepatic clamp but also more favorable results. No complications attributable to combined usage of MTC and vascular clamp were emerged.<br>We concluded that combination of MTC and hepatic vascular occlusion was very useful for safer hepatic resection.

収録刊行物

• Ｊｏｕｒｎａｌ　ｏｆ　Ｍｉｃｒｏｗａｖｅ　Ｓｕｒｇｅｒｙ

  Ｊｏｕｒｎａｌ　ｏｆ　Ｍｉｃｒｏｗａｖｅ　Ｓｕｒｇｅｒｙ 17 101-105, 1999

  特定非営利活動法人 Microwave Surgery研究会

キーワード

• hepatectomy
• vascular occulusion
• microwave tissue coagulator

詳細情報

• CRID: 1390282680157378816
• NII論文ID: 130000066823
• DOI: 10.3380/jmicrowavesurg.17.101
• ISSN: 1882210X
• ISSN: 09177728
• Web Site: https://search.jamas.or.jp/link/ui/2001239757
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可