Department of Hepatobiliary Pancreatic Surgery, West China Hospital, Sichuan University, Cheng du, Sichuan Province, China.
PLoS One. 2013;8(3):e60153. doi: 10.1371/journal.pone.0060153. Epub 2013 Mar 21.
Laparoscopic hepatectomy (LH) for management of hepatic colorectal metastases (HCRM) is commonly being performed; however, there are limited reports comparing LH outcomes with those of open hepatectomy (OH) procedure. The aim of the present study was to compare perioperative outcomes between the LH and OH procedures performed at a single medical center.
From Jan 2008 to May 2012, 30 patients with pathologically confirmed HCRM underwent LH, and 140 patients underwent OH at our hospital. Patients' demographics, perioperative outcomes were retrospectively analyzed.
2 patients (6.7%) in the LH group underwent laparotomies for intraoperative hemorrhage. The LH group had an increased surgical duration (235 min vs. 365 min, (P<0.001), shorter hospital stay (7.5 days vs. 11.5 days, P<0.001), and fewer complications (26.2% vs. 55%, P<0.001) than the OH group. However, in a matched cohort comparison of 30 LH cases and 30 OH cases, no significant variations were observed in the following parameters: surgical duration (235 min vs. 255 min, P = 0.23), positive margin rates (6.7% vs. 0.0%, P = 0.27), or postoperative hematological changes. LH patients had less estimated blood loss (215 ml vs. 385 ml, P<0.001), less morbidity (26.2% vs. 50%, P = 0.02), shorter hospital stay (7.5 days vs. 11.5 days, P<0.001), and lower analgesic requests than with those in the OH group.
LH for metastatic colorectal cancer is a safe and feasible treatment, even in patients who underwent prior laparotomy surgeries and provides significantly less morbidity and shorter hospital stay than OH, without compromising curability or increasing morbidity.
腹腔镜肝切除术（LH）常用于治疗结直肠肝转移（HCRM）；然而，将 LH 与开腹肝切除术（OH）的结果进行比较的报道有限。本研究旨在比较单中心 LH 和 OH 手术的围手术期结果。
2008 年 1 月至 2012 年 5 月，30 例经病理证实的 HCRM 患者接受 LH，140 例患者在我院接受 OH。回顾性分析患者的人口统计学和围手术期结果。
LH 组有 2 例（6.7%）患者因术中出血行剖腹术。LH 组手术时间（235 分钟 vs. 365 分钟，P<0.001）、住院时间（7.5 天 vs. 11.5 天，P<0.001）和并发症（26.2% vs. 55%，P<0.001）均少于 OH 组。然而，在 30 例 LH 病例和 30 例 OH 病例的匹配队列比较中，手术时间（235 分钟 vs. 255 分钟，P = 0.23）、阳性切缘率（6.7% vs. 0.0%，P = 0.27）或术后血液学变化无显著差异。LH 患者出血量（215 毫升 vs. 385 毫升，P<0.001）、发病率（26.2% vs. 50%，P = 0.02）、住院时间（7.5 天 vs. 11.5 天，P<0.001）和镇痛需求均少于 OH 组。
LH 治疗转移性结直肠癌是一种安全可行的治疗方法，即使是在先前接受过剖腹手术的患者中也是如此，与 OH 相比，LH 可显著降低发病率和缩短住院时间，而不会影响治愈率或增加发病率。
