Endo Yuichi, Ohta Masayuki, Sasaki Atsushi, Kai Seiichiro, Eguchi Hidetoshi, Iwaki Kentaro, Shibata Kohei, Kitano Seigo
Department of Surgery I, Oita University Faculty of Medicine, Oita, Japan.
Surg Laparosc Endosc Percutan Tech. 2009 Oct;19(5):e171-4. doi: 10.1097/SLE.0b013e3181bc4091.
Laparoscopic hepatectomy was initially reported in 1992. However, the reported experiences are scarce, and this operation has not been a standard procedure until now. The aims of this study were to assess our results of laparoscopy-assisted left lateral hepatectomy for hepatocellular carcinoma (HCC) and to compare them with those of open conventional procedures.
From 1984 to 2002, left lateral hepatectomy for HCC less than 5 cm in diameter was carried out in 21 patients. Ten patients received a laparoscopy-assisted procedure, and remaining 11 patients received an open procedure.
There were no significant differences in the operation time, blood loss, resected liver weight, and resection margin between the 2 groups. The total time that analgesics were given, body temperature on postoperative day 1, weight loss on postoperative day 7, and postoperative hospital stay in the laparoscopic group were significantly better than in the conventional group. With regard to the long-term prognosis, there were no differences in patient survival or disease-free survival rates between the 2 groups.
Laparoscopy-assisted left lateral hepatectomy for HCC is superior to the conventional open surgery in terms of its short-term results and does not cause the long-term survival to deteriorate. Therefore, laparoscopic hepatectomy may be an alternative choice for treatment of HCC.
腹腔镜肝切除术最初于1992年被报道。然而，相关报道的经验较少，直至目前该手术仍未成为标准术式。本研究的目的是评估我们采用腹腔镜辅助左外叶肝切除术治疗肝细胞癌（HCC）的结果，并与传统开腹手术的结果进行比较。
1984年至2002年，对21例直径小于5 cm的HCC患者实施左外叶肝切除术。其中10例患者接受腹腔镜辅助手术，其余11例患者接受开腹手术。
两组在手术时间、出血量、切除肝脏重量及切缘方面无显著差异。腹腔镜组在镇痛药物使用总时长、术后第1天体温、术后第7天体重减轻情况及术后住院时间方面均显著优于传统手术组。在长期预后方面，两组患者的生存率或无病生存率无差异。
对于HCC，腹腔镜辅助左外叶肝切除术在短期结果方面优于传统开腹手术，且不会导致长期生存率下降。因此，腹腔镜肝切除术可能是治疗HCC的一种替代选择。
