完全腹腔镜和开腹肝切除手术治疗原发性肝细胞肝癌的近期和远期疗效比较

发布时间：2019-03-05 14:06

【摘要】：目的:探讨腹腔镜肝切除术(LLR)治疗肝细胞肝癌(HCC)的近期和远期疗效。方法:收集同期LLR和开腹肝切除术(OLR)治疗HCC的临床资料,比较相关临床指标。结果:两组患者在年龄、性别、Child-Pugh分级、肝硬化、甲胎蛋白以及肝炎携带等方面均无统计学差异(均P0.05)。LLR组中转开腹1例,OLR组围手术期死亡1例。与OLR组相比,LLR组平均手术时间较长(P0.05)、术中失血量较大(P0.05)。除规则肝切除亚组术后肝功能指标大部分恢复更快外(大部分P0.05),其余亚组肝功能指标大部分无显著差异。但LLR组术后VAS评分更低,下床活动时间)、术后进食时间、术后住院时间更短(均P0.05)。两组患者术后并发症的发生、分布以及严重并发症发生率比较,均无差异(均P0.05)。LLR和OLR术后无瘤生存率(χ~2=0.55,P=0.46)及累积生存率(χ~2=1.06,P=0.30)比较差异没有显著性。结论:LLR治疗HCC创伤小,恢复快,远期疗效好,是一种安全、有效的手术方法。
[Abstract]:Objective: to evaluate the short-term and long-term efficacy of laparoscopic hepatectomy (LLR) in the treatment of hepatocellular carcinoma (HCC) with (HCC). Methods: the clinical data of HCC treated with LLR and open hepatectomy (OLR) were collected, and the related clinical indexes were compared. Results: there was no significant difference in age, sex, Child-Pugh grade, cirrhosis, alpha-fetoprotein and hepatitis carrier between the two groups (P0.05, 1 case in). LLR group, 1 case in OLR group, 1 case died in perioperative period). Compared with OLR group, the average operative time and blood loss in LLR group were longer (P0.05) and larger (P0.05). In addition to regular hepatectomy subgroup, most of the liver function indexes recovered more quickly (most P0.05), and most of the other subgroups had no significant difference in liver function indexes. But in LLR group, the scores of VAS were lower, the time of out-of-bed activity was lower, the time of eating and hospitalization were shorter after operation (all P0.05). There was no significant difference in the incidence, distribution and incidence of severe complications between the two groups (P0.05). The disease-free survival rate (蠂 ~ 2 / 0.55, P = 0.46) and cumulative survival rate (蠂 ~ 2 / 1.06, 蠂 ~ 2 / OLR) were not significantly different between the two groups (P < 0.05). There was no significant difference between the two groups (P < 0. 30). Conclusion: LLR is a safe and effective method for the treatment of HCC with the advantages of less trauma, faster recovery and better long-term effect.
【作者单位】：四川省医学科学院·四川省人民医院肝胆胰外科;
【基金】：四川省科技厅重点研发项目(编号:2017SZ0069)
【分类号】：R735.7

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