摘要
目的探讨解剖性肝中叶切除治疗中央型肝癌的可行性及近期疗效。方法回顾性分析2007年1月至2011年12月收治的85例原发性中央型肝癌（单发，无远处转移），按照手术方式分为解剖性肝中叶切除术组（A组）共36例，非解剖性肝中叶切除术组（B组）共49例，比较手术策略，术中情况，术后并发症及近期复发转移情况。结果2组术中出血量差异无统计学意义（P〉0．05）；各组术中输血量差异无统计学意义（P〉0．05）；A组术后住院时间及总住院费用明显优于B组（P〈0．05）；A组手术时间较B组长，2组比较差异有统计学意义（P〈0．05）；并发症发生人数和发生人次2组有明显统计学差异；A组复发转移7例，占该组的19．4％（7／36）；而非解剖组复发转移20例，占该组的40．8％（20／49），2组比较差异有统计学意义（P〈0．05）。结论解剖性肝中叶切除具有手术打击小，术中出血少，术后渗出及并发症少，复发转移率低等优点，可作为治疗中央型肝癌的首选手术方式。
Objective To compare the efficacies of anatomic and nonanatomic mesohepatectomy for central type hepatocellular carcinoma. Methods The clinical data of 85 patients with central type hepatocellular carcinoma undergoing hepatectomies were retrospectively analysed. 36 patients underwent anatomic mesohepatectomy and the other 49 patients did nonanatomic mesohepatectomy. The operative time, intraoperative blood loss, incidence of postoperative complications, postoperative drainage volume, time to flatus and length of postoperative stay between the two groups were compared. Results There were no significant differences in the general condition, organ function, tumor size and location between the two groups before operation （ P 〉 0.05 ）. The intraoperative blood loss, incidence of postoperative complications, drainage volume were significantly less but the operative time longer in anatomic mesohepatectomy group than nonanatomic hepatectomy group （P 〈 0. 05 ）. No differences between the two groups were found in regard to the time for flatus and length of postoperative hospital stay （ P 〉 0. 05 ）. Tumor recurrence developed in 7 cases in group A and 20 cases in group B （ P 〈 O. 05 ）. Conclusions Anatomic mesobepatectomy has the advantages of less surgical trauma, less exudation and complications in patients with central type hepatocellular carcinoma.
出处
《中华普通外科杂志》
CSCD
北大核心
2014年第1期13-16,共4页
Chinese Journal of General Surgery
关键词
癌
肝细胞
肝切除术
Carcinoma,hepatocellular
Hepatectomy
