Updates Surg. 2014 Jun;66(2):127-33. doi: 10.1007/s13304-014-0252-5.
Laparoscopic liver surgery has not yet gained widespread acceptance among liver surgeons. Some questions remain regarding indications to surgery and health related quality of life (HRQOL) after surgery, especially for the treatment of benign lesions, has so far not yet been investigated. The aim of this study is to evaluate HRQOL at 1 month, 6 months and 1 year after surgery in two groups of patients undergoing liver resections for benign liver lesions either by laparoscopic or open surgery. From January 2004 to September 2010 75 patients underwent surgery (29 laparoscopic, 46 open) for benign liver lesions.We retrospectively compared surgical results of the two groups and evaluated HRQOL with the SF-36 test. A personal or telephonic interview was administrated for the assessment of HRQOL before surgical treatment and at1 month, 6 months and 1 year after surgery. Sixty six patients (88%) were available for the study. The length of stay (4.7 vs. 8.2 days, p = 0.0002), the reprisal of oral intake (II post-op vs. III post-op, p = 0.02) the number of transfused patients (2 vs. 8, p = 0.1) and the overall rate of morbidity (p = 0.06) were lower in the laparoscopic group.HRQOL was significantly better in the laparoscopic group in the first year after surgery. Surgical treatment for benign liver lesions, when indicated, should be laparoscopic. This approach shows a lower rate of surgical complications with a better quality of life after surgery and a faster reprisal of social and job activities.
腹腔镜肝手术尚未在肝外科医生中得到广泛认可。关于手术适应证和手术后健康相关生活质量(HRQOL)仍存在一些问题,特别是对于良性病变的治疗,目前尚未进行研究。本研究旨在评估两组接受腹腔镜或开放性肝切除术治疗良性肝病变的患者在手术后 1 个月、6 个月和 1 年内的 HRQOL。从 2004 年 1 月至 2010 年 9 月,75 例患者因良性肝病变接受手术(腹腔镜 29 例,开放性 46 例)。我们回顾性比较了两组的手术结果,并使用 SF-36 测试评估了 HRQOL。在手术治疗前和手术后 1 个月、6 个月和 1 年,通过个人或电话访谈进行 HRQOL 评估。66 例患者(88%)可用于研究。腹腔镜组的住院时间(4.7 天 vs. 8.2 天,p = 0.0002)、恢复口服摄入时间(II 术后 vs. III 术后,p = 0.02)、输血患者人数(2 例 vs. 8 例,p = 0.1)和总体发病率(p = 0.06)均较低。腹腔镜组在手术后第一年的 HRQOL 显著更好。当指征明确时,应采用腹腔镜治疗良性肝病变。这种方法显示出较低的手术并发症发生率,术后生活质量更好,社会和工作活动恢复更快。