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腹腔镜肝切除术对肝脏再生的影响。

Impact of laparoscopic liver resection on liver regeneration.

机构信息

Department of Surgery, Nara Medical University, 840 Shijo, Kashihara, Nara, 634-8522, Japan.

出版信息

Surg Endosc. 2022 Oct;36(10):7419-7430. doi: 10.1007/s00464-022-09155-4. Epub 2022 Mar 11.

Abstract

BACKGROUND

Liver regeneration after liver resection plays an important role in preventing posthepatectomy liver failure. In this study, we aimed to evaluate and compare the impact of laparoscopic liver resection (LLR) and open liver resection (OLR) on liver regeneration.

METHODS

Patients who underwent curative anatomical liver resection for hepatocellular carcinoma, cholangiocellular carcinoma, and colorectal liver metastases at our institution between January 2010 and December 2018 were included in this study. The patients were divided into the OLR and LLR groups. Preoperative liver volume (PLV), future remnant liver volume, resected liver volume (RLV), liver volume at 1 month after the surgery, and liver volume at 6 months after the surgery were calculated. The liver regeneration rate was defined as the increase in the rate of RLV, and the liver recovery rate was defined as the rate of return to the PLV.

RESULTS

The study included 72 patients. Among them, 43 were included in the OLR group and 29 were included in the LLR group. No differences were observed in the baseline characteristics and surgical procedures between the two groups. Moreover, no significant difference was observed in the liver regeneration rate at 1 month after the surgery (OLR vs. LLR: 68.9% vs. 69.0%, p = 0.875) and at 6 months after the surgery (91.8% vs. 93.2%, p = 0.995). Furthermore, the liver recovery rates were not significantly different between the two groups at 1 month after the surgery (90.3% vs. 90.6%, p = 0.893) and at 6 months after the surgery (96.9% vs. 98.8%, p = 0.986).

CONCLUSION

Liver regeneration after liver resection is not affected by the type of surgical procedure and both laparoscopic and open procedures yield similar regeneration and recovery rates.

摘要

背景

肝切除术后的肝脏再生对于预防肝切除术后肝功能衰竭起着重要作用。本研究旨在评估和比较腹腔镜肝切除术(LLR)和开腹肝切除术(OLR)对肝脏再生的影响。

方法

本研究纳入了 2010 年 1 月至 2018 年 12 月在我院接受根治性解剖性肝切除术治疗肝细胞癌、胆管细胞癌和结直肠癌肝转移的患者。患者被分为 OLR 组和 LLR 组。计算术前肝脏体积(PLV)、剩余肝脏体积、切除肝脏体积(RLV)、术后 1 个月肝脏体积和术后 6 个月肝脏体积。肝脏再生率定义为 RLV 的增加率,肝脏恢复率定义为 PLV 的恢复率。

结果

本研究共纳入 72 例患者,其中 OLR 组 43 例,LLR 组 29 例。两组患者的基线特征和手术方式无差异。此外,术后 1 个月的肝脏再生率(OLR 组与 LLR 组:68.9%比 69.0%,p=0.875)和术后 6 个月的肝脏再生率(91.8%比 93.2%,p=0.995)也无显著差异。此外,术后 1 个月和 6 个月的肝脏恢复率在两组之间也无显著差异(术后 1 个月:90.3%比 90.6%,p=0.893;术后 6 个月:96.9%比 98.8%,p=0.986)。

结论

肝切除术后的肝脏再生不受手术方式的影响,腹腔镜和开腹手术均可获得相似的再生和恢复率。

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