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[老年肝细胞癌患者的腹腔镜肝切除术——单中心经验]

[Laparoscopic Liver Resection for the Elderly Hepatocellular Carcinoma Patients-A Single Institutional Experience].

作者信息

Kihara Yukari, Takeda Yutaka, Ohmura Yoshiaki, Katsura Yoshiteru, Shinke Go, Kinoshita Mitsuru, Aoyama Shu, Yanagisawa Kiminori, Katsuyama Shinsuke, Ikeshima Ryo, Hiraki Masayuki, Sugimura Keijiro, Masuzawa Toru, Hata Taishi, Murata Kohei

机构信息

Dept. of Surgery, Kansai Rosai Hospital.

出版信息

Gan To Kagaku Ryoho. 2022 Dec;49(13):1762-1764.

Abstract

INTRODUCTION

Laparoscopic liver resection(LLR)has been reported as a safe, minimally invasive, and effective approach to the management of liver tumor. The aim of this study was to analyze the perioperative results and outcomes of LLR for the elderly hepatocellular carcinoma(HCC)patients and to compare to the non-elderly HCC patients.

PATIENTS AND METHOD

Between May 2010 and November 2021, 725 patients(HCC 407, CRC Mets 171, others 147)patients underwent LLR at Kansai Rosai Hospital. 407 patients who underwent LLR for HCC were divided into 2 groups those who were over 80 years old(n=67)and under 79 years old(n=340). The patient age was 82.7 and 68.8 years, while the male to female ratio was 41/26 and 238/102 in the elderly and non-elderly groups, respectively. According to the liver cancer study group of Japan, the pathological Stage 0/Ⅰ/Ⅱ/Ⅲ/Ⅳ was 23/34/8/2 and 117/146/57/20 patients(p=0.1086)in the elderly and non- elderly groups, respectively. This study was approved by the Human Ethics Review Committee of Kansai Rosai Hospital(Certificate Number: 2101006).

RESULTS

The elderly group had an average operation time of 316.1 minutes, an estimated blood loss of 277.3 g, and a hospital stay of 14.3 days. The non-elderly group had an average operation time of 347.2 minutes, an estimated blood loss of 233.7 g, and a hospital stay of 12.9 days. No significant differences were noted between the elderly patients and the non-elderly patients with respect to the rate of procedure, operation time, intraoperative blood loss, hospital stay, morbidity, and postoperative laboratory data.

CONCLUSION

The LLR was undergone in safety, even for the over 80 years old patients. The results of LLR for HCC over 80 years old were comparable both in short-term results with under 79 years old group. It was considered that the minimally invasiveness of LLR allows comparable surgical treatment for the elderly with non-eldery.

摘要

引言

腹腔镜肝切除术(LLR)已被报道为一种安全、微创且有效的肝肿瘤治疗方法。本研究的目的是分析老年肝细胞癌(HCC)患者行LLR的围手术期结果和预后,并与非老年HCC患者进行比较。

患者与方法

2010年5月至2021年11月期间,725例患者(HCC 407例、结直肠癌肝转移171例、其他147例)在关西罗萨医院接受了LLR。407例行LLR治疗HCC的患者被分为两组,年龄超过80岁的患者(n = 67)和79岁及以下的患者(n = 340)。老年组和非老年组患者的年龄分别为82.7岁和68.8岁,男女比例分别为41/26和238/102。根据日本肝癌研究组的标准,老年组和非老年组病理分期为0/Ⅰ/Ⅱ/Ⅲ/Ⅳ期的患者分别为23/34/8/2例和117/146/57/20例(p = 0.1086)。本研究经关西罗萨医院人类伦理审查委员会批准(证书编号:2101006)。

结果

老年组平均手术时间为316.1分钟,估计失血量为277.3克,住院时间为14.3天。非老年组平均手术时间为347.2分钟,估计失血量为233.7克,住院时间为12.9天。老年患者与非老年患者在手术率、手术时间、术中失血量、住院时间、发病率及术后实验室数据方面均无显著差异。

结论

即使是80岁以上的患者,LLR也是安全可行的。80岁以上HCC患者行LLR的短期结果与79岁及以下组相当。LLR的微创性使得老年患者与非老年患者能够接受类似的手术治疗。

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