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开放手术与腹腔镜肝切除术治疗复发性肝细胞癌的短期疗效比较:一项单中心回顾性研究

Comparison of the short-term outcomes of open and laparoscopic hepatectomy in the treatment of recurrent hepatocellular carcinoma: a single-center retrospective study.

作者信息

Wang Ke, Sun Jian-Nan, Wu Sheng-Dong, Lu Cai-De, Hu Yang-Ke, Ma Yi-Jie

机构信息

Department of Hepatopancreatobiliary Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, China.

出版信息

Transl Cancer Res. 2022 Dec;11(12):4373-4380. doi: 10.21037/tcr-22-2576.

DOI:10.21037/tcr-22-2576
PMID:36644175
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9834575/
Abstract

BACKGROUND

To retrospectively analyze the short-term outcomes between open hepatectomy (OH) and laparoscopic hepatectomy (LH) in the treatment of recurrent hepatocellular carcinoma (HCC). The objective is to develop the optimal surgical method for patients with recurrent liver cancer after operation.

METHODS

We retrospectively reviewed the data of 165 HCC patients whose cancer recurred after hepatectomy between January 2015 and March 2021 at our medical center. According to the inclusion and exclusion criteria, a total of 74 patients were eventually enrolled in this study.

RESULTS

Tumors located in S1, S7, or S8 and larger tumor diameters were more frequent in the OH group, and the difference was statistically significant. Furthermore, there were notable differences between the LH and OH groups in terms of intraoperative blood loss (140.00 348.68 mL, P<0.001), mean operation time (150.95 203.28 min, P=0.024), and mean postoperative hospital stay (6.76 11.28 days, P=0.014). There were no statistically significant differences in the remaining characteristics between the two groups. There was no significant difference in recurrence-free survival and overall survival between the two groups.

CONCLUSIONS

Compared with OH, LH can significantly reduce the amount of intraoperative blood loss and shorten the operation time and postoperative hospital stay. At the same time, laparoscopic surgery may be a better surgical approach for patients with tumors of smaller diameter located in segments 2 to 6.

摘要

背景

回顾性分析开腹肝切除术(OH)与腹腔镜肝切除术(LH)治疗复发性肝细胞癌(HCC)的短期疗效。目的是为术后复发性肝癌患者制定最佳手术方法。

方法

回顾性分析2015年1月至2021年3月在我院医疗中心肝切除术后癌症复发的165例HCC患者的数据。根据纳入和排除标准,最终共有74例患者纳入本研究。

结果

OH组肿瘤位于S1、S7或S8且肿瘤直径较大的情况更为常见,差异具有统计学意义。此外,LH组与OH组在术中失血量(140.00±348.68 mL,P<0.001)、平均手术时间(150.95±203.28分钟,P=0.024)和平均术后住院时间(6.76±11.28天,P=0.014)方面存在显著差异。两组其余特征无统计学差异。两组的无复发生存率和总生存率无显著差异。

结论

与OH相比,LH可显著减少术中失血量,缩短手术时间和术后住院时间。同时,腹腔镜手术对于位于第2至6段、直径较小肿瘤的患者可能是一种更好的手术方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68d1/9834575/c5ae55cb9874/tcr-11-12-4373-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68d1/9834575/3b380c3a319c/tcr-11-12-4373-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68d1/9834575/c5ae55cb9874/tcr-11-12-4373-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68d1/9834575/3b380c3a319c/tcr-11-12-4373-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68d1/9834575/c5ae55cb9874/tcr-11-12-4373-f2.jpg

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