Lee Su Yong, Lee Dong-Shik, Yun Sung Su, Cho Chan Woo
Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea.
J Minim Invasive Surg. 2020 Dec 15;23(4):179-185. doi: 10.7602/jmis.2020.23.4.179.
The aim of this study was to compare the short-term outcomes between laparoscopic liver resection (LLR) and open liver resection (OLR) in elderly patients with hepatic tumors.
From January 2013 to December 2019, a retrospective study was conducted for a total of 143 patients with over 70 years of age, who underwent liver resection for hepatic tumors. Forty-five patients who received biliary reconstruction at the same time were excluded. According to surgical approaches, 98 patients were classified into LLR and OLR groups. All postoperative complications were classified according to the Clavien-Dindo grading system and the Comprehensive Complication Index (CCI).
Incidence of the postoperative complications was not statistically different between LLR and OLR groups. The CCI was significantly lower in the LLR group, with a median of 8.556, and a median of 19.698 in the OLR group (=0.042). The length of hospital stay in the LLR group was significantly shorter than in the OLR group (=0.008).
LLR is safe and feasible as a treatment for hepatic tumor in elderly patients with potentially less postoperative complications compared to OLR.
本研究旨在比较老年肝肿瘤患者腹腔镜肝切除术（LLR）和开腹肝切除术（OLR）的短期疗效。
对2013年1月至2019年12月期间共143例年龄超过70岁、因肝肿瘤接受肝切除术的患者进行回顾性研究。排除45例同时接受胆道重建的患者。根据手术方式，将98例患者分为LLR组和OLR组。所有术后并发症均根据Clavien-Dindo分级系统和综合并发症指数（CCI）进行分类。
LLR组和OLR组术后并发症发生率无统计学差异。LLR组CCI显著更低，中位数为8.556，OLR组中位数为19.698（=0.042）。LLR组住院时间显著短于OLR组（=0.008）。
与OLR相比，LLR作为老年肝肿瘤患者的一种治疗方法是安全可行的，术后并发症可能更少。
