Haruna Kengo, Katsura Yoshiteru, Takeda Yutaka, Ohmura Yoshiaki, Sakamoto Takuya, Shinke Go, Katsuyama Shinsuke, Kawai Kenji, Kitahara Tomohiro, Hiraki Masayuki, Kagawa Yoshinori, Masuzawa Toru, Takeno Atsushi, Hata Taishi, Murata Kohei
Dept. of Surgery, Kansai Rosai Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2388-2390.
Laparoscopic liver resection is not only minimally invasive but also reduces blood loss and postoperative complications compared to open surgery. Laparoscopic liver resection has been reported to be non-inferior to open resection in long term results. The indications for laparoscopic liver resection is expected to expand for patients with cirrhosis. In this study, we evaluated the safety and outcome of 96 cases of laparoscopic liver resection for hepatocellular carcinoma(HCC)in cirrhosis comparing with 32 cases of open liver resection performed in our hospital. Comparing laparoscopic and open liver resection cases(laparoscopic/open), the operative time was 304.2/211.0 minutes(p=0.003), blood loss was 459.8/1,102.0 g(p= 0.027)and post-operative hospital stay was 16.2/14.7 days(p=0.760). In laparoscopic surgery, operation time was longer, but the amount of blood loss was less, and post-operative hospital stay was comparable. In terms of postoperative complications, surgical site infections occurred in 5(5.2%)/5(15.6%)(p=0.068)and postoperative bleeding occurred in 2 (2.1%)/1(3.1%)(p=0.736), postoperative cholestasis occurred in 3(3.1%)/0(0.0%)(p=0.312)and mortality was 1(1.0%)/1(3.1%)(p=0.411), there was no significant difference. Laparoscopic liver resection can be safely performed in HCC patients with cirrhosis, and the results were as good as those of open liver resection.
与开腹手术相比，腹腔镜肝切除术不仅创伤小，而且能减少失血和术后并发症。据报道，腹腔镜肝切除术的长期效果不劣于开腹切除术。预计腹腔镜肝切除术在肝硬化患者中的适应证将会扩大。在本研究中，我们评估了96例腹腔镜肝切除术治疗肝硬化肝细胞癌（HCC）的安全性和疗效，并与我院同期进行的32例开腹肝切除术进行比较。比较腹腔镜和开腹肝切除术病例（腹腔镜/开腹），手术时间分别为304.2/211.0分钟（p = 0.003），失血量分别为459.8/1102.0克（p = 0.027），术后住院时间分别为16.2/14.7天（p = 0.760）。在腹腔镜手术中，手术时间较长，但失血量较少，术后住院时间相当。在术后并发症方面，手术部位感染发生率分别为5（5.2%）/5（15.6%）（p = 0.068），术后出血发生率分别为2（2.1%）/1（3.1%）（p = 0.736），术后胆汁淤积发生率分别为3（3.1%）/0（0.0%）（p = 0.312），死亡率分别为1（1.0%）/1（3.1%）（p = 0.411），差异均无统计学意义。腹腔镜肝切除术可安全应用于肝硬化HCC患者，其效果与开腹肝切除术相当。
