微创腹腔镜与传统开腹肝切除术治疗肝癌的近期疗效观察

Short-term efficacy of minimally invasive laparoscopic surgery and traditional open surgery for liver cancer

目的探讨微创腹腔镜与传统开腹肝切除术治疗肝癌的近期效果。方法选取2013年2月至2015年2月间武汉大学人民医院收治的40例肝癌手术患者,采用自愿原则分为研究组与对照组,每组20例。研究组患者采用微创腹腔镜治疗,对照组患者采用传统开腹肝切除术治疗,对比两组患者术中情况、术后恢复情况、手术前后血清指标、1年内生存率和局部复发率及转移率。结果研究组患者手术出血量低于对照组,术后排气时间、下床活动时间、引流管留置时间、进食时间及住院时间均低于对照组,两组比较,差异均有统计学意义(均P<0.05)。研究组患者术后血清白细胞介素-6、降钙素原、人基质金属蛋白酶-13和细胞间黏附分子-1水平均优于对照组,两组比较,差异均有统计学意义(均P<0.05)。2组患者手术时间、1年内生存率、局部复发率及转移率对比,差异均无统计学意义(均P>0.05)。结论微创腹腔镜肝切除术与传统开腹肝切除术后的复发率、转移率与生存率无明显差异,且出血少、恢复快,住院时间短,值得临床推广。

Objective To compare minimally invasive laparoscopic hepatectomy versus traditional open surgery for liver cancer. Methods Select 40 patients who received surgery for liver cancer at Renmin Hospital of Wuhan University between February 2013 to February 2015. According the intention of each patients,these patients were divided into a study group and a control group with 20 patients in each group. Patients in the study group underwent minimally invasive laparoscopic surgery and patients in the control group underwent traditional open surgery. Intraoperative and postoperative recovery,serum index before and after operation,1 year survival rate and the rate of local recurrence and metastasis were compared between the two groups. Results Bleeding amount,postoperative exhaust time,ambulation time,drainage tube indwelling time,feeding time and hospital stay was lower in the study group than in the control group（ all P 0. 05）. Postoperative serum interleukin-6（ IL-6）,procalcitonin（ PCT）,matrix metalloproteinase（ MMP-13） and intercellular adhesion molecule-1（ ICAM-1） levels were better in the the study group than control group（ all P 0. 05）. There was no statistically significant difference in operation time,1 year survival rate,local recurrence and metastasis rate between the two groups（ P 0. 05）. Conclusion Minimally invasive laparoscopic surgery showed no obvious difference in metastasis and recurrence rate and survival rate compared with the traditional liver resection,with less bleeding and faster recovery,which shortened the hospitalization period.