Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, PR China; Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, PR China.
Int J Surg. 2020 May;77:15-21. doi: 10.1016/j.ijsu.2020.03.003. Epub 2020 Mar 13.
Single port laparoscopic hepatectomy has been applied in some surgeries. We aimed to describe our experience with single port laparoscopic left lateral sectionectomy (SPLS) and to compare the safety and feasibility of this technique with those of conventional multi-port laparoscopic left lateral sectionectomy (MPLS) in the treatment of hepatocellular carcinoma (HCC).
A total of 72 consecutive patients who underwent SPLS (n = 33) and MPLS (n = 39) for HCC were enrolled. The peri-operative parameters of safety and feasibility, as well as the short-term oncological outcomes were compared.
The length of postoperative hospital stay (LOS) was significantly shorter in the SPLS group than in the MPLS group (4.12 vs. 4.59 days, P = 0.043). No significant difference between the two groups was found in the operation time (104.58 vs. 95.69 min in the SPLS group and MPLS group respectively, P = 0.353) or the amount of blood loss (62.73 vs. 68.46 ml, P = 0.595). The 1-year recurrence-free survival rate was 77.9% in the SPLS group and 70.7% in the MPLS group (P = 0.82). Subgroup analysis showed that for patients without cirrhosis, the LOS was shorter in the SPLS group than in the MPLS group (P = 0.033), while for patients with cirrhosis, the LOS was not significantly different between the two groups (P = 0.201), although it was shorter in the SPLS group.
SPLS was a feasible and safe surgical approach for the treatment of HCC on left lateral section.
单孔腹腔镜肝切除术已应用于某些手术中。我们旨在描述单孔腹腔镜左外叶切除术（SPLS）的经验，并比较该技术与传统多孔腹腔镜左外叶切除术（MPLS）治疗肝细胞癌（HCC）的安全性和可行性。
共纳入 72 例连续接受 SPLS（n=33）和 MPLS（n=39）治疗 HCC 的患者。比较了围手术期安全性和可行性的参数，以及短期肿瘤学结果。
SPLS 组的术后住院时间（LOS）明显短于 MPLS 组（4.12 天比 4.59 天，P=0.043）。两组手术时间（SPLS 组和 MPLS 组分别为 104.58 分钟和 95.69 分钟，P=0.353）或出血量（SPLS 组 62.73 毫升和 MPLS 组 68.46 毫升，P=0.595）均无显著差异。SPLS 组和 MPLS 组 1 年无复发生存率分别为 77.9%和 70.7%（P=0.82）。亚组分析显示，对于无肝硬化患者，SPLS 组的 LOS 短于 MPLS 组（P=0.033），而对于肝硬化患者，两组之间的 LOS 无显著差异（P=0.201），尽管 SPLS 组的 LOS 较短。
SPLS 是治疗左外叶 HCC 的一种可行且安全的手术方法。
