腹腔镜规则性肝切除治疗肝细胞癌的疗效分析

Efficacy of Laparoscopic Anatomical Hepatectomy for the Treatment of Hepatic Cellular Cancer

目的:探讨腹腔镜规则性肝切除治疗肝细胞癌(HCC)的疗效。方法:回顾性分析深圳市人民医院2010年1月至2013年12月收治的64例HCC患者的临床资料,按手术方式和1∶1配对的研究方法分成腹腔镜组及开腹手术组,比较两种手术方式的临床疗效。结果:实施腹腔镜肝切除和开腹肝切除各32例,腹腔镜组无中转开腹,术中出血量(325±86.63)ml与开腹手术组(530±119.21)ml相比明显减少(P<0.05)。两组术后病理检查均证实HCC,切缘阴性。腹腔镜组术后禁食时间及腹腔引流留留置时间均明显小于开腹手术组(P<0.05),但肝功能的恢复、并发症发生率和1年内肿瘤复发率与开腹手术组相比无统计学差异(P>0.05)。结论:腹腔镜规则性肝切除治疗HCC安全、有效而且微创,值得推广。

Objective： To investigate the efficacy of laparoscopic anatomical hepatectomy for the treatment of hepatic cellular cancer（HCC）. Methods： The clinical data of 64 HCC patients who were admitted to the Shenzhen People＇s Hospital from January 2010 to December 2013 were retrospectively analyzed.All patients were divided into the laparoscopic anatomical hepatectomy（LAH） group（32 patients） and open anatomical hepatectomy（OAH） group（32patients） according to the operation patterns and at the ratio of 1∶1.The clinical efficacy of two surgical methods was compared. Results： The patients applied with LAH and OAH were 32 cases, respectively. No case was converted to laparotomy in LAH group. The volume of blood loss of the LAH group was（325±86.63） ml, which was significantly lower than（530±119.21） ml of the OAH group（P0.05）. Pathological examination confirmed the HCC in the two-group with negative margin. Fasting time and abdominal cavity drainage time and retention of LAH group were significantly less than OAH group（P0.05）, but recovery of liver function, complications and tumor recurrence rate within 1 year compared with OAH group, no significant difference. Conclusion： Laparoscopic anatomical hepatectomy for HCC is safe, effective and minimally invasive, it is worth promoting.