Han Dai Hoon, Choi Sung Hoon, Park Eun Jung, Kang Dae Ryong, Choi Gi Hong, Choi Jin Sub
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Robot & MIS Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Int J Med Robot. 2016 Dec;12(4):735-742. doi: 10.1002/rcs.1714. Epub 2015 Nov 4.
This study was designed to compare perioperative and oncologic outcomes between minimally invasive liver resection (MILR) and conventional open liver resection (COLR) for hepatocellular carcinoma (HCC) using a propensity-score matched analysis.
Ninety-nine patients who received MILR were matched with 198 patients treated with COLR out of 928 patients with HCC who received curative liver resection from 2002 to 2012. A multivariable logistic model based on factors related to the patient, tumor, and surgical procedure was used to estimate a propensity score.
The MILR group experienced significantly less intraoperative blood loss (mean: 389.55 vs 580.66 mL; P = 0.008), lower complication rates (13.1% vs 24.7%; P = 0.020), and a shorter length of hospital stay (mean: 8.40 vs 13.39 days; P < 0.001). The two groups did not differ significantly in disease-free (P = 0.701) or overall survival (P = 0.086).
MILR produced better perioperative and comparable oncologic outcomes than COLR for HCC. Copyright © 2015 John Wiley & Sons, Ltd.
本研究旨在通过倾向评分匹配分析，比较微创肝切除术（MILR）与传统开放性肝切除术（COLR）治疗肝细胞癌（HCC）的围手术期和肿瘤学结局。
在2002年至2012年接受根治性肝切除术的928例HCC患者中，99例行MILR的患者与198例行COLR的患者进行匹配。基于与患者、肿瘤和手术相关的因素建立多变量逻辑模型来估计倾向评分。
MILR组术中出血量显著更少（平均：389.55 vs 580.66 mL；P = 0.008），并发症发生率更低（13.1% vs 24.7%；P = 0.020），住院时间更短（平均：8.40 vs 13.39天；P < 0.001）。两组在无病生存期（P = 0.701）或总生存期（P = 0.086）方面无显著差异。
对于HCC，MILR比COLR产生更好的围手术期结局且肿瘤学结局相当。版权所有© 2015约翰威立父子有限公司。
