Matsukuma Satoshi, Tokumitsu Yukio, Nakagami Yuki, Shindo Yoshitaro, Matsui Hiroto, Nakajima Masao, Iida Michihisa, Suzuki Nobuaki, Takeda Shigeru, Nagano Hiroaki
Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Department of Translational Research and Developmental Therapeutics Against Cancer, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Surg Endosc. 2021 Dec;35(12):7131-7141. doi: 10.1007/s00464-020-08233-9. Epub 2021 Jan 4.
Laparoscopic liver resection is beneficial compared to open liver resection. This study aimed to evaluate whether laparoscopic liver resection could reduce postoperative infections.
This study included 125 and 115 patients with liver tumors who underwent open and pure laparoscopic partial resections or left lateral sectionectomies, respectively. Propensity score matching and stabilized inverse probability of treatment weighting were carried out to compare the postoperative infectious complication rates between the two groups.
Patients with tumors located in Couinaud segment 1, 7, or 8; with tumors adjacent to major vessels; or who underwent repeated resections were more likely to receive open resection. After propensity score matching, the superficial incisional surgical site infection rate tended to be lower in the laparoscopic liver resection group than in the open liver resection group. Moreover, overall infectious complication rate and superficial incisional surgical site infection rate were lower in the laparoscopic group (the cohort formed by the stabilized inverse probability of treatment weighting).
Using the laparoscopic approach for partial resections and left lateral sectionectomies for liver tumors, the superficial incisional surgical site infection rate could be reduced.
与开放性肝切除术相比，腹腔镜肝切除术具有优势。本研究旨在评估腹腔镜肝切除术是否能降低术后感染率。
本研究分别纳入了125例和115例肝肿瘤患者，他们分别接受了开放性和单纯腹腔镜下部分切除术或左外叶切除术。采用倾向评分匹配法和稳定的逆概率处理加权法来比较两组患者术后感染性并发症的发生率。
肿瘤位于肝Couinaud 1、7或8段的患者，肿瘤毗邻大血管的患者，或接受过再次手术的患者更有可能接受开放性切除术。倾向评分匹配后，腹腔镜肝切除组的浅表切口手术部位感染率往往低于开放性肝切除组。此外，腹腔镜组（由稳定的逆概率处理加权法形成的队列）的总体感染性并发症发生率和浅表切口手术部位感染率更低。
采用腹腔镜方法进行肝肿瘤的部分切除术和左外叶切除术，可降低浅表切口手术部位感染率。
