腹腔镜肝部分切除术的临床研究

The Clinical Study of the Liver Parts of Resections of Laparoscope

目的探讨腹腔镜肝部分切除术(1aparoscopic hepatectomy,LH)的安全性、可行性及其与传统开腹肝切除术(open hepatectomy,OH)相比较的优越性,分析其临床应用价值。方法收集我院肝移植腔镜外科2007年1月至2010年6月间肝部分切除术病例,根据手术方式不同分为腹腔镜肝切除组和开腹肝切除组,每组各15例;主要比较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。结果腹腔镜肝切除组和开腹肝切除组年龄、性别、体重、肿块直径的差异没有统计学意义;切口长度在2组间比较差异有统计学意义(P=0.000)。腹腔镜肝切除组和开腹肝切除组手术时间分别为(170.00±92.25,181.67±53.31,P=0.676);2组术中出血量:(250.00±136.28mL,393.33±194.45mL,P=0.027);术后进食时间:(1.33±0.49,3.6±70.62,P=0.000);术后住院时间:(6.80±1.47,16.87±7.78,P=0.000);比较腹腔镜肝切除组和开腹肝切除组2组手术方式患者近期并发症发生率差异无统计学意义(P=0.441)。结论研究结果显示,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、术后恢复快、术后住院时间短等优点,在临床上值得推广。

Objective To investigate the safety and feasibility of laparoscopic hepatectomy（LH）,and evaluate the advantage compared with open hepatectomy（OH）.Methods Thirty cases were selectted in my hospital from January 2007 to June 2010,and were divided into LH group and OH group. Data of patients of two groups were compared,which included surgical operation time the volume of hemorrhage,the complications,the time of eating food after operation,the time stay in the hospital.Rvsults The two groupe has no significant difference in Age,Sexy,Weight and Tumor diameter.There was significant difference in Length of incision（P=0.000）. the operation time of two sections （170.00±92.25,181.67±53.31,P=0.676）the volume of hemorrhage（250.00±136.28,393.33±194.45, P=0.027）.the time of eating food after operation （1.33±0,49,3.674±0.62 P=0.000）the time stay in the hospital （6.80±1.47,16.87±7.78 P=0.000）.There was no significant difference in the complications（P=0.441）.Condusion Laparoscopic liver resection is a safe and feasibility approach in clinically selected patient hepatetomy in laparoscope have micro trauma and the good effectiveness.It has the high value clinical application.compared with OH,LH for selected patient is perspective mininvasive and safe technique,it was suitable to performed in our country.