Ker C G, Chen J S, Kuo K K, Chuang S C, Wang S J, Chang W C, Lee K T, Chen H Y, Juan C C
Division of HBP Surgery, Chung-Ho Memorial Hospital, Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan.
Int J Hepatol. 2011;2011:596792. doi: 10.4061/2011/596792. Epub 2011 May 16.
In this study, we try to compare the benefit of laparoscopic versus open operative procedures. Patients and Methods. One hundred and sixteen patients underwent laparoscopic liver resection (LR) and another 208 patients went for open liver resection (OR) for hepatocellular carcinoma (HCC). Patients' selection for open or laparoscopic approach was not randomized. Results. The CLIP score for LR and OR was 0.59 ± 0.75 and 0.86 ± 1.04, respectively, (P = .016). The operation time was 156.3 ± 308.2 and 190.9 ± 79.2 min for LR and OR groups, respectively. The necessity for blood transfusion was found in 8 patients (6.9%) and 106 patients (50.9%) for LR and OR groups. Patients resumed full diet on the 2nd and 3rd postoperative day, and the average length of hospital stay was 6 days and 12 days for LR and OR groups. The complication rate and mortality rate were 0% and 6.0%, 2.9% and 30.2% for LR and OR groups, respectively. The 1-yr, 3-yr, and 5-yr survival rate was 87.0%, 70.4%, 62.2% and 83.2%, 76.0%, 71.8% for LR and OR group, respectively, of non-significant difference. From these results, HCC patients accepted laparoscopic or open approach were of no significant differences between their survival rates.
在本研究中，我们试图比较腹腔镜手术与开放手术的益处。患者与方法。116例患者接受了腹腔镜肝切除术（LR），另外208例患者因肝细胞癌（HCC）接受了开放肝切除术（OR）。患者对开放或腹腔镜手术方式的选择并非随机进行。结果。LR组和OR组的CLIP评分分别为0.59±0.75和0.86±1.04，（P = 0.016）。LR组和OR组的手术时间分别为156.3±308.2分钟和190.9±79.2分钟。LR组和OR组分别有8例（6.9%）和106例（50.9%）患者需要输血。患者在术后第2天和第3天恢复正常饮食，LR组和OR组的平均住院时间分别为6天和12天。LR组和OR组的并发症发生率和死亡率分别为0%和6.0%，2.9%和30.2%。LR组和OR组的1年、3年和5年生存率分别为87.0%、70.4%、62.2%和83.2%、76.0%、71.8%，差异无统计学意义。从这些结果来看，接受腹腔镜或开放手术的HCC患者生存率之间无显著差异。
