摘要
目的:比较两种经Glisson蒂鞘解剖路径肝切除术治疗原发性肝癌(PHC)的肿瘤学疗效及风险。方法:回顾性收集2018年2月至2021年5月行肝切除术的115例PHC患者病例资料,根据术式不同分为鞘内组(n=60例,行Glisson蒂鞘内阻断法肝切除术)和鞘外组(n=55例,行Glisson蒂鞘外阻断法肝切除术)。采用SPSS 23.0统计软件分析数据,手术相关指标等以(x±s)表示,采用独立样本t检验;总缓解率采用秩和检验,并发症采用χ^(2)检验。采用Kaplan-Meier进行生存分析,行Log-Rank检验。P<0.05为差异有统计学意义。结果:鞘外组患者手术时间、缺血线出现时间、术中出血量均低于鞘内组(P<0.05);两组患者住院时间、总缓解率、并发症总发生率、术后2年复发率及术后2年总生存率相比,差异无统计学意义(P>0.05)。结论:两种经Glisson蒂鞘解剖路径肝切除术治疗PHC具有相似的肿瘤学疗效和短期预后,但与经Glisson蒂鞘内阻断法相比,经Glisson蒂鞘外阻断法可有效减少手术时间及术中出血。
Objective:To compare the oncologic efficacy and risk of hepatectomy via Glisson pedicle sheath anatomical route in the treatment of primary liver cancer(PHC).Methods:The medical data of 115 PHC patients who underwent hepatectomy from February 2018 to May 2021 were retrospectively collected,and were divided into intrathecal group(n=60 patients undergoing intrathecal resection with Glisson pedicle occlusion)and extrathecal group(n=55 patients undergoing intrathecal resection with Glisson pedicle occlusion)according to different operation methods.SPSS 23.0 statistical software was used to analyze the data.Surgical indicators were expressed as(x±s)and independent sample t test was used.The overall response rate was tested by Rank Sum test and the complications were tested byχ^(2) test.Survival analysis was performed by Kaplan-Meier and Log-Rank test was performed.P<0.05 was considered statistically significant.Results:Operative time,ischemic line occurrence time and intraoperative blood loss in extrinsic group were lower than those in intrathecal group(P<0.05).There was no significant difference in length of hospital stay,total remission rate,total complication rate,2-year postoperative recurrence rate and 2-year postoperative survival rate between 2 groups(P>0.05).Conclusion:The two types of intrathecal resection via Glisson pedicle anatomical route have similar oncologic efficacy and short-term prognosis for PHC.However,compared with intrathecal resection via Glisson pedicle,intrathecal resection via Glisson pedicle can effectively reduce operative time and intraoperative bleeding.
作者
曾繁利
齐秩凯
杨贺庆
Zeng Fanli;Qi Zhikai;Yang Heqing(Department of General Surgery,Qinhuangdao Second Hospital,Qinhuangdao Hebei Province 066600,China)
出处
《中华普外科手术学杂志(电子版)》
2024年第5期525-527,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
河北省医学科学研究重点课题计划项日(20191164)。
关键词
原发性肝癌
肝切除术
Glisson蒂鞘
手术后并发症
复发
生存率
Primary Liver Cancer
Hepatectomy
Glisson Pedicle Sheath
Postoperative Complications
Recurrence
Survival Rate