Zhang Yunhao, Hu Tao, Wang Zhao, Yuan Jianlei
Department of Hepatobiliary and Pancreatic Minimally Invasive Surgery, Cangzhou People's Hospital Cangzhou 061000, Hebei, China.
Am J Transl Res. 2024 Mar 15;16(3):897-904. doi: 10.62347/QBBO2532. eCollection 2024.
Precision liver resection is considered the gold standard in liver surgery. Therefore, optimizing the resection of lesions and minimizing unnecessary time of liver ischemia and hypoxia have become focal points.
A total of 96 patients with primary liver cancer admitted to Cangzhou People's Hospital from January 2017 and December 2019 were included in this retrospective study, and divided into two groups according to the different surgical treatment, with 50 cases in the control group (conventional hepatic resection) and 46 cases in the observation group (precision liver resection). The surgical indicators, liver function, alpha-fetoprotein (AFP), complications, and three-year follow-up results were analyzed in the two groups.
The operation time, intraoperative bleeding, hospital stay, and time of anal venting in the observation group were shorter than those in the control group (P<0.05). One week after surgery, AST, TBiL, ALT, and γ-GT levels decreased in both groups, with more significant decreases in the observation group than those in the control group (P<0.05). PCT and hs-CRP levels in the observation group were significantly lower than those in the control group (P<0.05) observation. The incidences of pleural effusion, bile leak, abdominal infection, pulmonary infection, as well as the total complication rates in the observation group were lower in the observation group than those in the control group (P<0.05). The follow-up data revealed that the observation group exhibited a lower recurrence rate observationand higher survival rate than the control group within 3 years, but these differences were not significant (P>0.05).
Precision liver resection can effectively treat primary liver cancer, reduce the incidence of complications, and promote patient recovery after surgery.
精准肝切除被认为是肝脏手术的金标准。因此,优化病灶切除并尽量减少肝脏缺血缺氧的不必要时间已成为重点。
本回顾性研究纳入了2017年1月至2019年12月在沧州市人民医院收治的96例原发性肝癌患者,根据不同的手术治疗方法分为两组,对照组50例(传统肝切除术),观察组46例(精准肝切除术)。分析两组的手术指标、肝功能、甲胎蛋白(AFP)、并发症及三年随访结果。
观察组的手术时间、术中出血量、住院时间及肛门排气时间均短于对照组(P<0.05)。术后一周,两组的AST、总胆红素(TBiL)、ALT及γ-谷氨酰转移酶(γ-GT)水平均下降,观察组下降更显著(P<0.05)。观察组的降钙素原(PCT)及超敏C反应蛋白(hs-CRP)水平显著低于对照组(P<0.05)。观察组的胸腔积液、胆漏、腹腔感染、肺部感染发生率及总并发症发生率均低于对照组(P<0.05)。随访数据显示,观察组在3年内的复发率较低,生存率较高,但差异无统计学意义(P>0.05)。
精准肝切除可有效治疗原发性肝癌,降低并发症发生率,促进患者术后恢复。