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腹腔镜辅助非解剖性肝切除术治疗肝硬化患者右后段肝细胞癌的安全性和可行性:一项倾向评分匹配的病例对照研究

Safety and Feasibility of a Laparoscopy-Assisted Non-Anatomic Resection Technique for Hepatocellular Carcinoma Located at Right Posterior Segments in Cirrhotic Patients: A Case-Controlled Study with Propensity Score Matching.

作者信息

Jin Haosheng, Yin Zi, Zhou Yu, Ma Tingting, Jian Zhixiang

出版信息

Dig Surg. 2018;35(5):411-418. doi: 10.1159/000480359. Epub 2017 Sep 12.

DOI:10.1159/000480359
PMID:28892808
Abstract

PURPOSE

The aim of this study was to compare the short- and long-term outcomes of laparoscopy-assisted resection for right posterior segment (LAR-RPS) with open resection (OR-RPS) performed by experienced hepatobiliary surgeons.

METHODS

This was a prospective comparative nonrandomized study.

RESULTS

The groups were comparable in terms of baseline demographics and clinicopathological data. Reduced operative time (254.88 ± 78.56 vs. 347.95 ± 82.56 min; p = 0.04) and estimated blood loss (477 ± 756 vs. 712 ± 836 mL; p = 0.03) were observed in LAR-RPS. Also, significant less duration of hospital stay (7.53 ± 2.68 vs. 12.57 ± 3.21 days; p < 0.001) was associated with LAR-RPS compared to OR-RPS. Long-term oncologic outcomes were comparable in 2 groups, in terms of both the overall and disease-free survival rates (p = 0.450 and 0.463, respectively).

CONCLUSIONS

This study confirms that laparoscopic-assisted resection is a safe and effective operative procedure in those cirrhotic patients with a lesion in the right posterior section of the liver. When compared to the open approach, the laparoscopic-assisted approach reduces operative time and blood loss, as well as the length of hospital stay.

摘要

目的

本研究旨在比较经验丰富的肝胆外科医生进行的腹腔镜辅助右后段切除术(LAR-RPS)与开放切除术(OR-RPS)的短期和长期结果。

方法

这是一项前瞻性比较非随机研究。

结果

两组在基线人口统计学和临床病理数据方面具有可比性。LAR-RPS组的手术时间缩短(254.88±78.56 vs. 347.95±82.56分钟;p = 0.04),估计失血量减少(477±756 vs. 712±836毫升;p = 0.03)。此外,与OR-RPS相比,LAR-RPS组的住院时间明显缩短(7.53±2.68 vs. 12.57±3.21天;p < 0.001)。两组的长期肿瘤学结果在总生存率和无病生存率方面具有可比性(分别为p = 0.450和0.463)。

结论

本研究证实,腹腔镜辅助切除术对于肝右后段有病变的肝硬化患者是一种安全有效的手术方法。与开放手术相比,腹腔镜辅助手术可减少手术时间、失血量以及住院时间。

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Efficacy of Laparoscopic Hepatectomy Open Surgery for Hepatocellular Carcinoma With Cirrhosis: A Meta-analysis of Case-Matched Studies.腹腔镜肝切除术与开腹手术治疗肝硬化肝细胞癌的疗效:病例匹配研究的Meta分析
Front Oncol. 2021 May 7;11:652272. doi: 10.3389/fonc.2021.652272. eCollection 2021.