单孔腹腔镜在肝癌治疗的安全性及可行性研究

Safety and feasibility of single port laparoscopic hepatectomy for hepatocellular carcinoma:a retrospective study

目的探讨经脐单孔腹腔镜肝左外叶切除术在原发性肝癌治疗中的安全性及可行性。方法回顾性收集2017年1-9月于中山大学肿瘤防治中心行腹腔镜左外叶肝癌切除术的患者28例,收集研究对象的临床资料并建立数据库。对计数资料使用百分比表示并进行χ2检验;对计量资料使用x珋±s表示并进行t检验。对比分析单孔腹腔镜手术与常规腹腔镜手术在术中出血量、手术时间、术后肝功能恢复和住院时间等方面的区别。结果其中6例患者成功行单孔腹腔镜左外叶肝癌切除术,无一例中转开腹或增加切口。单孔腹腔镜手术在术中出血、术后肝功能恢复和住院时间等方面与常规腹腔镜手术比较,差异无统计学意义(P>0.05)。单孔腹腔镜手术的手术时间较常规腹腔镜手术有所增加[(143.3±57.2)min vs(93.2±22.8)min,P<0.05]。所有患者术后无感染、腹水及胆漏等并发症发生。结论单孔腹腔镜左外叶肝癌切除术具有和常规腹腔镜手术相当的安全性及可行性,但对术者的手术操作技术提出了更高的要求。

Objective To explore the safety and feasibility of transumbilical single port laparoscopic left lateral hepatectomy for hepatocellular carcinoma. Methods Clinical data of 28 patients who underwent laparoscopic left lateral hepatectomy in Sun Yat-sen University Cancer Center（SYSUCC） from Jan. to Sep. 2017 were collected. Database was established and analyzed retrospectively. The quantitative data was expressed as percentage and X2 test; qualitative data was measured as the x - ± s deviation and t test. Additionally, intraoperative bleeding, operation time, postoperative liver function recovery and hospitalization were compared between single and multiple port laparoscopic hepatectomy, respectively. Results 6 patients were performed with single port laparoscopic left lateral hepatectomy successfully, no case of conversion to laparotomy or adding incision. There was no clinically significant difference between two groups in terms of intraoperative bleeding, postoperative liver function recovery, and hospitalization （P 〉 0.05 ）. However, the operation time of single port laparoscopic hepatectomy was longer than the conventional laparoscopicsurgery [（143.3 ± 57.2）min vs（93.2 ± 22.8）min, P〈 0.05]. There was no case of postoperative infection, peritoneal effusion and leakage or other complications. Conclusions Single port laparoscopic left lateral hepatectomy was provided with the similar safety and feasibility as conventional laparoscopic surgery. Whereas, the procedures put forward higher technical requirement to surgeons.