腹腔镜肝切除术治疗小肝癌临床分析  

Clinical analysis of laparoscopic hepatectomy for small hepatocellular carcinoma

作　　者：宋举贤[1] 陈健[2] 李建伟[2] 范毓东[2] 王小军[2] 郑树国[2] 

机构地区：[1]解放军第44医院肝胆外科,贵阳550000 [2]第三军医大学西南医院全军肝胆外科研究所

出　　处：《临床外科杂志》2017年第3期179-182,共4页Journal of Clinical Surgery

摘　　要：目的探讨腹腔镜肝切除术(LH)治疗小肝癌的临床疗效。方法回顾分析2007年1月~2013年12月第三军医大学西南医院102例行LH治疗小肝癌患者的临床资料。结果102例患者中中转开腹4例,中转开腹率为3.9%,并发症发生率为29.4%,手术时间(189.6±76.9)分钟,术中失血量(284.6±278.6)ml,术中输血率为3.9%,全肠外营养使用率为6.9%,住院时间为(16.1±5.5)天。中位随访时间为44.5个月,1年、3年总体生存率为95.3%、82.6%,相应的总体无瘤生存率为80.4%、58.2%。亚组分析中肝前下段组和肝后上段组在围手术期数据和随访结果比较,差异均无统计学意义(P>0.05)。结论 LH创伤小,恢复快,并发症发生率低,腹腔镜肝切除术在肝前下段和肝后上段切除具有相同的近期和远期效果。Objective To evaluate the clinical effect of laparoscopic hepatectomy for small bepa- tocellular carcinoma. Methods We retrospectively analyzed the medical records of 102 patients undergoing laparoscopic hepatectomy for small hepatocellular carcinoma from January 1,2007 to December 31, 2013 at the Southwest Hospital Mfiliated to the Third Military Medical University. Results Four patients were converted to laparotomy, and the rate of conversion to laparotomy was 3.9%. The overall complication rate was 29.4%. The total operative time was （ 189.6 ± 76.9 ）min, intraoperative blood loss （284.6 ± 278.6） ml,intraoperative blood transfusion rate was 3.9% （4/102）, total parenteral nutrition utilization rate was 6.9% （ 7/102 ） d and hospital stay was （ 16.1 ± 5.5 ） d. The median follow-up time was 44.5 months, 1-, and 3-year overall survival rate were 95.3% and 82.6%. The corresponding overall diseasefree survival rate：80.4% ,58.2%. In the subgroup analysis, there was no statistically significant difference between the anterolateral liver segment group （ Ⅱ , Ⅲ, Ⅳ b, Ⅴ, and Ⅵ ） and the posterosuperior liver seg- ment group （ Ⅰ , Ⅳ a, Ⅶ, and Ⅷ）in the perioperative data and follow-up results （P 〉 0.05 ）. Conclusion Laparoscopic hepatectomy had the advantages of small trauma, quick recovery and low incidence of com- plications. Laparoscopic bepatectomy had the same short-term and long-term effects in the anterolateral liver segment and posterosuperior liver segment resection.

关 键 词：腹腔镜肝切除术 小肝癌 微创 

分 类 号：R735.7[医药卫生—肿瘤]