手助腹腔镜在肝癌切除术中的临床应用分析

Hand-assisted laparoscopic resection of hepatic carcinoma

目的探讨手助腹腔镜在肝癌切除术中临床应用的价值。方法将近期手术切除的47例原发性肝癌随机分为3组:手助腹腔镜肝癌切除术(I组)16例,单纯腹腔镜肝癌切除术(Ⅱ组) 14例,开放式肝癌切除术(Ⅲ组)17例,对其治疗及效果进行统计分析。采用SPSS11．0软件,应用单因素方差分析法(One-Way ANOVA),组间比较采用LSD检验。结果I组与Ⅱ组的手术时间分别为3．46 h及4．06 h(P<0．001),其差异有显著性;I组与Ⅲ组的术中出血量、住院时间、肝功能影响、近期并发症率分别为119．38 ml及238．82 ml(P<0．001),8．31 d及10．53 d(P<0．001),47．13 U／L及125．53 U／L(P<0．001),0．00％及23．53％(P=0．014),其差异有显著性。结论手助腹腔镜肝癌切除术具有微创、安全、效果好等优势,有较高的临床应用价值。

Objective To determine the value of hand-assisted laparoscopic resection of hepatic carcinoma Methods The clinical data of 47 patients with hepatic carcinoma receiving surgical treatment in our hospital were collected. The 47 patients were randomized into 3 groups. Sixteen patients in group A were given hand-assisted laparoscopic resection, 14 in group B underwent laparoscopic re- section and 17 in group C received open resection. Then statistical analysis was performed using the software SPSS11. 0. Results The operative duration was significantly different between group A and group B （3.46 h vs. 4.06 h, P〈0. 001）. Meanwhile, there were remarkable differences in blood loss （119.38 ml vs. 238. 82 ml, P〈0. 001）, duration of hospitalization （8. 31 d vs. 10. 53 d, P〈0. 001）, increase of postoperative ALT level （47.13 U/L vs. 125.53 U/L, P〈0. 001） and incidence of postoperative complications （0 vs. 23.53%, P〈0. 05） between group A and group C. Conclusions Hand-assisted laparoscopic resection of hepatic carcinoma is feasible, safe and effective.