Liu Qinqin, Liu Fei, Ding Jingjing, Wei Yonggang, Li Bo
Department of Liver Surgery, Center of Liver Transplantation, West China Hospital.
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.
Medicine (Baltimore). 2019 Feb;98(6):e14485. doi: 10.1097/MD.0000000000014485.
The main objective of the study was to compare the surgical outcomes and quality of life (QOL) of patients with hepatic hemangioma either by laparoscopic or open surgery using a propensity score analysis.We retrospectively reviewed patients with hepatic hemangioma undergoing laparoscopic liver surgery (LLS) or open liver surgery (OLS) between January 2016 and December 2017. Intraoperative and postoperative characteristics, and quality of life, according to Short Form-36 Healthy Survey (SF-36) questionnaire, were compared between groups. We performed 1:1 propensity score matching (PSM) between the LLS and OLS groups.A total of 205 patients who involved in the analysis (80 LLS vs 125 OLS) were matched (1:1) by age, gender, body mass index (BMI), American Society of Anesthesiologists (ASA) score, previous upper abdominal surgery, comorbidities, operation method, type of resection, tumor localization, size, and number. After PSM, 73 well-matched patients in each group were obtained. LLS was associated with significantly less blood loss, shorter postoperative hospital stay and fewer complications. The QOL scores weren't significantly different between the 2 groups, though the LLS group tended to be superior to the OLS group in terms of bodily pain (BP) and mental health (MH) at 3 months after surgery.In comparison with the conventional open approach, laparoscopic liver surgery for hepatic hemangioma appears to have improved short-term surgical outcomes and comparable QOL in selected patients.
本研究的主要目的是通过倾向得分分析比较肝血管瘤患者接受腹腔镜手术或开放手术的手术结果和生活质量（QOL）。我们回顾性分析了2016年1月至2017年12月期间接受腹腔镜肝手术（LLS）或开放肝手术（OLS）的肝血管瘤患者。比较两组患者的术中及术后特征，以及根据简明健康调查问卷（SF-36）得出的生活质量。我们在LLS组和OLS组之间进行了1:1倾向得分匹配（PSM）。共有205例纳入分析的患者（80例LLS vs 125例OLS）按年龄、性别、体重指数（BMI）、美国麻醉医师协会（ASA）评分、既往上腹部手术史、合并症、手术方式、切除类型、肿瘤定位、大小和数量进行了（1:1）匹配。PSM后，每组获得73例匹配良好的患者。LLS与显著更少的失血量、更短的术后住院时间和更少的并发症相关。两组的QOL评分无显著差异，尽管LLS组在术后3个月的身体疼痛（BP）和心理健康（MH）方面倾向于优于OLS组。与传统开放手术相比，腹腔镜肝手术治疗肝血管瘤似乎在选定患者中改善了短期手术结果并具有相当的生活质量。
