Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Anticancer Res. 2024 Sep;44(9):3931-3936. doi: 10.21873/anticanres.17221.
BACKGROUND/AIM: No studies have investigated the advantage of laparoscopic hepatectomy (LH) compared with open hepatectomy (OH) from a nutritional perspective. This study aimed to compare the postoperative nutritional status between LH and OH.
A total of 186 patients who underwent partial hepatic resection for liver tumors were analyzed retrospectively. We compared perioperative variables between LH and OH. The nutritional status was assessed using serum albumin (Alb) and rapid turnover protein concentrations. We investigated risk factors for postoperative malnutrition using univariate and multivariate analyses.
The LH group, compared with the OH group, had a significantly shorter operative time (239 vs. 344 min, p<0.03), less intraoperative blood loss (100 vs. 343 g, p<0.01), and a shorter length of postoperative stay (8 vs. 11 days, p<0.01). Postoperative serum Alb and prealbumin concentrations in the LH group were significantly higher than those in the OH group (3.4 vs. 3.2 g/dl, p<0.01; 15.0 vs. 12.0 mg/dl, p=0.02, respectively). The multivariate analysis showed that OH (p=0.02) and hepatocellular carcinoma (p<0.01) were significant and independent risk factors for postoperative malnutrition.
LH may be superior to OH in terms of the postoperative nutritional status, intraoperative blood loss, and length of postoperative stay.
背景/目的：目前尚无研究从营养角度比较腹腔镜肝切除术（LH）与开腹肝切除术（OH）的优势。本研究旨在比较 LH 和 OH 术后的营养状况。
回顾性分析了 186 例行部分肝切除术治疗肝肿瘤的患者。我们比较了 LH 和 OH 两组之间的围手术期变量。采用血清白蛋白（Alb）和快速周转蛋白浓度评估营养状况。使用单因素和多因素分析探讨了术后营养不良的危险因素。
与 OH 组相比，LH 组的手术时间明显缩短（239 分钟比 344 分钟，p<0.03），术中出血量减少（100 克比 343 克，p<0.01），术后住院时间缩短（8 天比 11 天，p<0.01）。LH 组术后血清 Alb 和前白蛋白浓度明显高于 OH 组（3.4 克/分升比 3.2 克/分升，p<0.01；15.0 毫克/分升比 12.0 毫克/分升，p=0.02）。多因素分析显示，OH（p=0.02）和肝细胞癌（p<0.01）是术后营养不良的独立危险因素。
LH 在术后营养状况、术中出血量和术后住院时间方面可能优于 OH。
