论文部分内容阅读
目的:探讨腹腔镜肝切除术(LLR)治疗肝细胞肝癌(HCC)的近期和远期疗效。方法:收集同期LLR和开腹肝切除术(OLR)治疗HCC的临床资料,比较相关临床指标。结果:两组患者在年龄、性别、Child-Pugh分级、肝硬化、甲胎蛋白以及肝炎携带等方面均无统计学差异(均P<0.05)。LLR组中转开腹1例,OLR组围手术期死亡1例。与OLR组相比,LLR组平均手术时间较长(P<0.05)、术中失血量较大(P<0.05)。除规则肝切除亚组术后肝功能指标大部分恢复更快外(大部分P<0.05),其余亚组肝功能指标大部分无显著差异。但LLR组术后VAS评分更低,下床活动时间)、术后进食时间、术后住院时间更短(均P<0.05)。两组患者术后并发症的发生、分布以及严重并发症发生率比较,均无差异(均P>0.05)。LLR和OLR术后无瘤生存率(χ~2=0.55,P=0.46)及累积生存率(χ~2=1.06,P=0.30)比较差异没有显著性。结论:LLR治疗HCC创伤小,恢复快,远期疗效好,是一种安全、有效的手术方法。
Objective: To investigate the short-term and long-term effects of laparoscopic liver resection (LLR) in the treatment of hepatocellular carcinoma (HCC). Methods: Clinical data of LLR and OLR in the treatment of HCC during the same period were collected and compared with related clinical indexes. Results: There was no significant difference between the two groups in age, gender, Child-Pugh classification, cirrhosis, alpha-fetoprotein, and hepatitis carrier (all P <0.05). One case of laparotomy in LLR group and one case of perioperative death in OLR group. Compared with OLR group, the average operation time of LLR group was longer (P <0.05), blood loss was larger (P <0.05). Except regular liver resection subgroups, postoperative liver function indexes mostly recovered faster (most P <0.05), while most of the remaining subgroups had no significant difference. However, postoperative VAS score was lower in the LLR group and the time spent in bed was shorter than that in the LLR group), postoperative eating time and postoperative hospital stay (all P <0.05). No significant difference was found in the incidence of postoperative complications, distribution and incidence of serious complications between the two groups (all P> 0.05). There was no significant difference between the two groups in LLR and OLR (χ ~ 2 = 0.55, P = 0.46) and cumulative survival (χ ~ 2 = 1.06, P = 0.30). Conclusion: LLR is a safe and effective surgical method for the treatment of HCC with small trauma, rapid recovery and long-term curative effect.