腹腔镜肝部分切除术的临床应用价值

Clinical application value of parts of liver resections under laparoscope

目的探讨腹腔镜肝部分切除术(LH)的安全性、可行性及其与传统开腹肝切除术(OH)相比较的优越性,分析其临床应用价值。方法收集30例肝部分切除术病例,根据手术方式不同分为腹腔镜组和开腹组,每组各15例,2组年龄、性别、体质量、肿块直径比较无显著性差异。比较2组手术时间、术中出血量、术后并发症、术后进食时间和住院时间的差异。结果切口长度2组比较有显著性差异(P=0.000);2组手术时间无显著性差异(P=0.676);开腹组的术中出血量比腹腔镜组多(P=0.027);开腹组术后进食时间比腹腔镜组长(P=0.000);开腹组术后住院时间比腹腔镜组长(P=0.000);2组近期并发症发生率无显著性差异(P=0.441)。结论腹腔镜肝切除术是安全、可行的手术方式,具有微创、术中出血量少、术后恢复快、术后住院时间短等优点,在临床上值得推广。

Objective It is to approach the safety and feasibility of laparoscope hepatectomy（LH） of parts of liver and the advantage compared with open hepatectomy（OH） and analyze the clinical application value of LH.Methods 30 patients who were treated with hepatectomy were collected and divided into laparoscope group and open group in which there was 15 cases according the different modus operandi.There were no significant differences on age,sex,body mass,diameter of lump between the two groups.The differences on operation time,volume of hemorrhage,complication,time of eating food after operation and Length of Stay between the two groups were compared.Results There was significant difference on length of incision between the two groups（P=0.000）.There were no significant difference on operation time between the two groups（P=0.676）.The volume of hemorrhage in open group was more than that in laparoscope group（P=0.027）.The time of eating food after operation in open group was longer than that in laparoscope group（P=0.000）.The Length of Stay in open group was longer than that in laparoscope group（P=0.000）.There was no significant difference on the incidence rate of complication rate between the two groups（P=0.441）.Conclusion LH is a safe and feasibility modus operandi and has the advantages of micro trauma,little volume of hemorrhage,quick recovery after operation and short Length of Stay,which is worth clinically extending.