Departments of General Surgery.
Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Surg Laparosc Endosc Percutan Tech. 2020 Apr;30(2):169-172. doi: 10.1097/SLE.0000000000000772.
Laparoscopic hepatectomy has been accepted widely due to its advantages as a minimally invasive surgery, but laparoscopic right posterior sectionectomy (LRPS) has rarely been reported. We aimed to explore the safety and feasibility of LRPS by comparing it with open surgical approaches.
Between January 2014 and July 2019, 51 patients who underwent right posterior sectionectomy were enrolled in this study. The patients' characteristics, intraoperative details, and postoperative outcomes were compared between 2 groups.
There were no statistically significant differences in the preoperative data. LRPS showed significantly less blood loss (P=0.001) and shorter hospital stay (P=0.002) than open right posterior sectionectomy, but hospital expenses (P=0.382), operative time (P=0.196), surgical margin (P=0.311), the rate of other complications, and the postoperative white blood cell count, alanine aminotransferase, aspartate aminotransferase, and total bilirubin showed no statistically significant differences between the 2 groups (P>0.05). For hepatocellular carcinoma, the results showed there were no differences in both disease-free survival (P=0.220) and overall survival (P=0.417) between the 2 groups.
Our research suggests that LRPS is a safe and feasible surgical procedure that is efficient from an oncological point of view. It may be the preferred choice for lesions in the right posterior hepatic lobe.
腹腔镜肝切除术因其微创的优势已被广泛接受,但腹腔镜右后叶切除术(LRPS)很少有报道。我们旨在通过与开放手术方法比较,来探讨 LRPS 的安全性和可行性。
在 2014 年 1 月至 2019 年 7 月期间,我们纳入了 51 例接受右后叶切除术的患者进行本研究。比较了两组患者的一般特征、手术细节和术后结果。
术前数据无统计学差异。LRPS 组术中出血量明显少于开放右后叶切除术组(P=0.001),术后住院时间也明显短于开放右后叶切除术组(P=0.002),但两组间住院费用(P=0.382)、手术时间(P=0.196)、手术切缘(P=0.311)、其他并发症发生率、术后白细胞计数、丙氨酸转氨酶、天冬氨酸转氨酶和总胆红素无统计学差异(P>0.05)。对于肝细胞癌,两组之间无病生存率(P=0.220)和总生存率(P=0.417)无差异。
我们的研究表明,LRPS 是一种安全可行的手术方法,从肿瘤学角度来看是有效的。对于右后叶肝内病变,它可能是首选的治疗方法。