摘要
目的比较开腹再次肝切除术(ORH)与腹腔镜再次肝切除术(LRH)治疗复发性肝细胞癌(HCC)的安全性及疗效。方法回顾分析2015年8月至2017年12月南方医科大学南方医院复发性HCC行再次肝切除术33例患者资料,男性24例,女性9例。根据再次手术方式分为ORH组(18例),LRH组(15例)。比较两组术前资料、手术相关指标以及术后指标。结果两组前次肝切除范围、两次手术间隔时间、肿瘤数目、肿瘤最大直径等术前资料比较,差异无统计学意义(P>0.05)。两组肝切除方式、肝门阻断比例及手术持续时间比较,差异无统计学意义(P>0.05)。LRH组术中出血量低于ORH组[(66.7±36.3)ml比(251.1±75.6)ml],差异有统计学意义(P<0.05)。两组住院费用、术后首次白细胞计数、术后并发症比较,差异无统计学意义(P>0.05)。与ORH组比较,LRH组术后首次中性粒细胞百分比[(88.2±3.7)%比(83.6±4.8)%]、住院时间[(9.8±3.7)d比(6.3±2.9)d]及恢复进食时间[(2.9±1.4)d比(1.2±0.4)d]减少,差异有统计学意义(P<0.05)。结论LRH是治疗复发性HCC安全、有效的外科手段,并在减少术中出血量、促进术后恢复进食、缩短住院时间方面有一定优势。
Objective To compare the safety and short-term efficacy of laparoscopic repeat hepatectomy (LRH) with open repeat hepatectomy (ORH) for recurrent hepatocellular carcinoma (rHCC). Methods The clinical data of 33 patients with rHCC who underwent hepatectomy at Nanfang Hospital, Southern Medical University from August 2015 to November 2017 were retrospectively analyzed. There were 24 males and 9 females. The patients were divided into LRH group (n=15) and ORH group (n=18). The preoperative clinical data, operative and postoperative data of the two groups were compared. ResultsNo significant differences were observed in the preoperative clinical data of the two groups, including the extent of the previous hepatectomy, the interval between the two surgeries, the number of tumors, and the maximum diameter of tumors. No significant differences were observed in the liver resection method, portal occlusion time and operation duration between the two groups. Blood loss was significantly lower in the LRH group [(66.7±86.1)ml vs.(251.1±75.6)ml, P<0.05]. The total hospitalization expenses, first postoperative white blood cell count, and hepatic insufficiency in the two groups were not significantly different (P>0.05). The postoperative diet recovery was significantly shorter (1.2±0.4) days vs.(2.9±1.4) days, the inflammation indicator NEU% was significantly decreased (83.6±4.8)% vs.(88.2±3.7)%, and the length of postoperative hospital stay (6.3±2.9) days vs.(9.8±3.7)days was significantly shorter in the LRH group (P<0.05). Conclusions LRH was safe and effective in the treatment of rHCC, LRH was superior in reducing intraoperative blood loss, promoting postoperative recovery and shortening hospital stay when compared to ORH.
作者
陈雪芳
谢浩荣
王恺
张起帆
周杰
Chen Xuefang;Xie Haorong;Wang Kai;Zhang Qifan;Zhou Jie(Department of Hepatobiliary Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2019年第3期175-178,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
肝切除术
癌
肝细胞
复发
腹腔镜
Hepatectomy
Carcinoma, hepatocellular
Recurrence
Laparoscopes
