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肝细胞癌腹腔镜肝切除的肿瘤学和临床结局比较

The comparison of oncologic and clinical outcomes of laparoscopic liver resection for hepatocellular carcinoma.

作者信息

Kim Sung-Jin, Jung Hwa-Kyung, Lee Dong-Shik, Yun Sung-Su, Kim Hong-Jin

机构信息

Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.

出版信息

Ann Surg Treat Res. 2014 Feb;86(2):61-7. doi: 10.4174/astr.2014.86.2.61. Epub 2014 Jan 22.

Abstract

PURPOSE

We evaluate the operative outcome and oncologic outcome of laparoscopic liver resection for hepatocellular carcinoma (HCC), and compare with open liver resection.

METHODS

From January 2004 to December 2012, clinical data of 70 patients who underwent laparoscopic liver resection for HCC (laparoscopic liver resection group, lapa-group) were collected and analyzed retrospectively. Control group (open liver resection group, open-group) were retrospectively matched, and compared with lapa-group.

RESULTS

Laparoscopic major liver resections were performed in 4 patients. Laparoscopic anatomical resections and nonanatomical resections were performed in 39 patients, and 31 patients, respectively. Mean operative time was shorter in lapa-group (215.5 ± 121.84 minutes vs. 282.30 ± 80.34 minutes, P = 0.001), mean intraoperative transfusion rate and total amount were small in lapa-group (24.28%, 148.57 ± 3,354.98 mL vs. 40.78%, 311.71 ± 477.01 mL). Open conversion occurred in 6 patients (8.57%) because of bleeding, inadequate resection, invisible mass on intraoperative ultrasonography, and tumor rupture. In lapa-group and open-group, 3-year disease-free survival rates were 58.3% ± 0.08%, and 62.6% ± 0.06%, respectively (P = 0.773). In lapa-group and open-group 3-year overall survival rates were 65.3% ± 0.8%, and 65.7% ± 0.6%, respectively (P = 0.610).

CONCLUSION

Laparoscopic liver resection for HCC is feasible and safe in a large number of patients, with reasonable operative and oncologic results.

摘要

目的

我们评估肝细胞癌(HCC)腹腔镜肝切除术的手术效果和肿瘤学效果,并与开腹肝切除术进行比较。

方法

回顾性收集并分析2004年1月至2012年12月期间70例行HCC腹腔镜肝切除术患者(腹腔镜肝切除组,laparoscopic liver resection group,lapa组)的临床资料。回顾性匹配对照组(开腹肝切除组,open liver resection group,open组)并与lapa组进行比较。

结果

4例患者行腹腔镜大肝切除术。39例患者和31例患者分别行腹腔镜解剖性切除和非解剖性切除。lapa组平均手术时间较短(215.5±121.84分钟对282.30±80.34分钟,P = 0.001),lapa组平均术中输血率和输血量较少(24.28%,148.57±3354.98毫升对40.78%,311.71±477.01毫升)。6例患者(8.57%)因出血、切除不充分、术中超声未发现肿块及肿瘤破裂而中转开腹。在lapa组和open组中,3年无病生存率分别为58.3%±0.08%和62.6%±0.06%(P = 0.773)。在lapa组和open组中,3年总生存率分别为65.3%±0.8%和65.7%±0.6%(P = 0.610)。

结论

对于大量患者,HCC腹腔镜肝切除术是可行且安全的,具有合理的手术和肿瘤学效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0362/3994603/c1fc5fa3201a/astr-86-61-g001.jpg

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