Kamiyama Toshiya, Tahara Munenori, Nakanishi Kazuaki, Yokoo Hideki, Kamachi Hirofumi, Kakisaka Tatsuhiko, Tsuruga Yosuke, Matsushita Michiaki, Todo Satoru
Hepatogastroenterology. 2014 Mar-Apr;61(130):405-9.
BACKGROUND/AIMS: The long-term prognosis for patients with hepatocellular carcinoma (HCC) who undergo laparoscopic hepatectomy has not been well compared with that for patients after open hepatectomy.
We analyzed patient survival (PS) and disease-free survival (DFS) of 310 consecutive patients who underwent primary hepatectomy between January 2001 and March 2010. The patients were divided into Group LAP (laparoscopic approach) (n = 24) and Group OPN (with open laparotomy) (n = 286). The median follow-up time was 60.9 months (range, 12.0-123.9 months).
The 5-, and 7-year PS rates of Group LAP were 87.9%, and 87.9%, and those of Group OPN were 82.2% and 69.3%, respectively (P = 0.5638). The 5-, and 7-year DFS rates of Group LAP were 47.1%, and 31.4%, and those of Group OPN were 29.4%, and 24.3%, respectively (P = 0.4594). Laparoscopic hepatectomy in patients of Group LAP resulted in a better outcome of blood loss (P = 0.0314), operative time (P < 0.0001), and hospital stay (P = 0.0008).
The long-term outcome of laparoscopic hepatectomy for patients with HCC was identified to be comparable to open hepatectomy with regard to PS and DFS. Laparoscopic hepatectomy is a promising therapeutic option for patients with HCC.
背景/目的：接受腹腔镜肝切除术的肝细胞癌（HCC）患者的长期预后与接受开腹肝切除术的患者相比，尚未得到充分比较。
我们分析了2001年1月至2010年3月期间连续接受初次肝切除术的310例患者的总生存期（PS）和无病生存期（DFS）。患者分为腹腔镜组（LAP组）（n = 24）和开腹组（OPN组）（n = 286）。中位随访时间为60.9个月（范围12.0 - 123.9个月）。
LAP组的5年和7年总生存率分别为87.9%和87.9%，OPN组分别为82.2%和69.3%（P = 0.5638）。LAP组5年和7年无病生存率分别为47.1%和31.4%，OPN组分别为29.4%和24.3%（P = 0.4594）。LAP组患者的腹腔镜肝切除术在失血（P = 0.0314）、手术时间（P < 0.0001）和住院时间（P = 0.0008）方面有更好的结果。
就总生存期和无病生存期而言，腹腔镜肝切除术治疗HCC患者的长期疗效与开腹肝切除术相当。腹腔镜肝切除术是HCC患者一种有前景的治疗选择。
