腹腔镜与开腹肝切除术治疗肝细胞癌的疗效比较

发布时间：2018-08-27 12:09

【摘要】：目的:探讨腹腔镜肝切除术(Laparoscopic hepatectomy,LH)与开腹肝切除术(Open hepatectomy,OH)治疗肝细胞癌(Hepatocellular carcinoma,HCC)的临床疗效。方法:回顾性分析2014年6月至2015年12月在新疆医科大学第一附属医院肝(移植)腔镜外科因肝细胞癌而施行肝切除术的42例患者的临床资料,按不同手术方式分为两组,其中LH组18例,OH组24例。所有患者均遵循自愿原则行手术治疗。通过统计分析两组患者的年龄、性别、肿瘤直径、肿瘤位置、手术切口长度、手术时间、术中出血量、术后首次进食时间、术后留置引流管时间、术后住院时间、术后并发症发生率、术后1年复发率等资料,比较两组间的差异。结果:所有手术均顺利完成,无术中死亡病例。两组患者术前的一般资料无显著差异(P0.05)。LH组患者在手术切口长度、术后首次进食时间、术后留置引流管时间、术后住院时间、术后并发症发生率上均明显小于OH组,且有显著差异(P0.05)。而在手术时间、术中出血量、术后1年复发率上无显著差异(P0.05)。结论:在病例选择适当时,LH是一种安全、有效的治疗肝细胞癌的手术方式,与传统的开腹手术相比,LH具有手术切口小、术后恢复快、术后并发症少、术后住院时间短等优势,值得临床推广。
[Abstract]:Objective: to evaluate the efficacy of laparoscopic hepatectomy (Laparoscopic hepatectomy,LH) and open hepatectomy (Open hepatectomy,OH) in the treatment of hepatocellular carcinoma (Hepatocellular carcinoma,HCC). Methods: the clinical data of 42 patients undergoing hepatectomy in endoscopic surgery for hepatocellular carcinoma in the first affiliated Hospital of Xinjiang Medical University from June 2014 to December 2015 were retrospectively analyzed and divided into two groups according to different surgical methods. There were 18 cases in LH group and 24 cases in OH group. All patients followed the voluntary principle of surgical treatment. The age, sex, tumor diameter, tumor location, operative incision length, operative time, intraoperative bleeding volume, first feeding time, postoperative indwelling tube time, postoperative hospitalization time were statistically analyzed in the two groups. The incidence of postoperative complications and recurrence rate of 1 year after operation were compared between the two groups. Results: all the operations were completed successfully, and there were no cases of intraoperative death. There was no significant difference in preoperative general data between the two groups (P0.05). The length of incision, the time of first feeding after operation, the time of indwelling drainage tube, the time of hospitalization, the incidence of postoperative complications in LH group were significantly lower than those in OH group. There was significant difference (P0.05). However, there was no significant difference in operative time, intraoperative bleeding volume and recurrence rate 1 year after operation (P0.05). Conclusion: LH is a safe and effective method for the treatment of hepatocellular carcinoma. Compared with the traditional open surgery, LH has the advantages of small incision, quick recovery, less postoperative complications and short postoperative hospital stay. It is worth popularizing in clinic.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7

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