精准肝脏外科在HCC治疗中的应用

Value of the fine liver surgery concept in the treatment of HCC

目的:精准肝脏外科理念在HCC治疗中的应用价值。方法:回顾性分析2010~2015年实施肝脏切除术的HCC患者121例,精准肝脏切除组45例,传统肝脏切除组76例,比较两组手术情况、术后情况、手术并发症以及随访结果。结果:精准肝脏切除组的手术时间长于传统肝脏切除组,术中出血量、输血量、输血率、肝门阻断率、住院时间均低于传统肝脏切除组(P<0.05);术后1 d、术后3 d和术后5 d的ALT和TB均低于传统肝脏切除组(P<0.05);术后并发症发生率(7例,15.56%)低于传统肝脏切除组(25例,32.89%,P<0.05);术后切缘癌残留率和复发率(4.44%、11.11%)低于传统肝脏切除组(17.11%、48.68%,P<0.05);术后第1年和第2年的生存率(92.17%、85.31%)高于传统肝脏切除组(90.58%、72.45%,χ~2=7.715,P=0.005)。结论:精准肝脏外科切除肝脏治疗HCC的疗效和安全性均优于传统肝脏切除术。

Objective： To investigate the value of fine liver surgery concept in the treatment of HCC. Methods： Retrospective analysis of 121 cases of HCC with liver resection in our hospital from September 2010 to September 2015, according to the operation method, they were divided into the fine liver resection group and the traditional liver resection group, the two groups of operation condi- tions, postoperative conditions, complications and follow-up results were compared. Results： The operation time of the fine liver resection group was longer than that of the traditional liver resection group, the amount of blood loss, blood transfusion, blood transfusion rate, hepatic portal occlusion rate, and the length of stay in the fine liver resection group were lower than those in the traditional liver resection group, and the difference was statistically significant （P〈0.05）; The ALT and TB in the patients with fine liver resection group postoperative 1 days, 3 days and 5 days were lower than those in the traditional liver resection group, and the difference was statistically significant（P〈O.05）; The incidence of postoperative complications in the fine liver resection group （7 cases, 15.56%） was lower than that in the conventional liver resection group （25 cases, 32.89%）, and the difference was statistically significant （P〈O.05）; The residual rate of resection margins and recurrence rate （4.44%, 11.11%） in the fine liver resection group were lower than that of conventional liver resection group （17.11%, 48.68%）, and the difference was statistically significant （P〈O.05）; The survival rate after precise liver resection 1 year and 2 years in the fine liver resection group （92.17%, 85.31%） was higher than that of traditional liver resection group（90.58%, 72.45%）, and the difference was statisti- cally significant （ X^2=7.715, P=O.O05）. Conclusion： The efficacy and safety of fine liver resection in the treatment of HCC was superior to that of conventional liver resection.