Noda Takehiro, Eguchi Hidetoshi, Iwagami Yoshifumi, Yamada Daisaku, Asaoka Tadafumi, Gotoh Kunihito, Kawamoto Koichi, Kobayashi Shogo, Hashimoto Yasuji, Takeda Yutaka, Tanemura Masahiro, Umeshita Koji, Doki Yuichiro, Mori Masaki
Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Department of Surgery, Yao Municipal Hospital, Osaka, Japan.
Hepatol Res. 2018 Jun;48(7):539-548. doi: 10.1111/hepr.13057. Epub 2018 Mar 7.
Minimally invasive liver resection (MILR) is considered a safe and feasible treatment for malignant liver tumors. However, few studies have investigated the surgical outcomes of MILR in patients with impaired liver function. Liver damage is used for consideration of hepatectomy. The aim of this study is to clarify the efficacy of MILR for patients with impaired liver function by using propensity score matching.
Ninety-nine patients with liver damage B underwent hepatic resection were analyzed. The patients were divided into two groups, the MILR group (n = 24) and the open liver resection (OLR) group (n = 75). After matching of a propensity score, we compared clinicopathological features and surgical outcomes.
After matching, 36 patients (18 patients from each group) were selected and the patients' characteristics and tumor characteristics were not significantly different between the two groups. Blood loss (P = 0.0163) and complication rate (P = 0.0162) were significantly decreased in the MILR group. Complications were observed in eight patients, comprising one patient in the MILR group and seven patients in the OLR group. The postoperative hospital stay was significantly shortened in the MILR group (P = 0.0118).
Minimally invasive liver resection might be effective for patients with impaired liver function. It reduces surgical complications and consequently shortens hospitalization time.
微创肝切除术（MILR）被认为是治疗恶性肝肿瘤的一种安全可行的方法。然而，很少有研究调查肝功能受损患者接受MILR的手术效果。肝损伤是肝切除术考虑的因素。本研究的目的是通过倾向评分匹配来阐明MILR对肝功能受损患者的疗效。
分析99例接受肝切除术的B级肝损伤患者。患者分为两组，MILR组（n = 24）和开放性肝切除术（OLR）组（n = 75）。在进行倾向评分匹配后，我们比较了临床病理特征和手术效果。
匹配后，选择了36例患者（每组18例），两组患者的特征和肿瘤特征无显著差异。MILR组术中出血量（P = 0.0163）和并发症发生率（P = 0.0162）显著降低。观察到8例患者出现并发症，其中MILR组1例，OLR组7例。MILR组术后住院时间显著缩短（P = 0.0118）。
微创肝切除术可能对肝功能受损患者有效。它可减少手术并发症，从而缩短住院时间。
