腹腔镜手术治疗复发性肝癌的安全性和疗效分析  

Efficacy and safety of laparoscopic surgery in treatment of recurrent hepatocellular carcinoma

作　　者：李林欢 宋政 周芬 田秉璋[1] 王方明 王俊[1] 吕品[1] 梁刚 欧晔 Li Linhuan;Song Zheng;Zhou Fen;Tian Bingzhang;Wang Fangming;Wang Jun;Lyu Pin;Liang Gang;Ou Ye(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Hunan Normal University(Hunan Provincial People's Hospital),Changsha 410005,China)

机构地区：[1]湖南师范大学附属第一医院(湖南省人民医院)肝胆外科,长沙410005

出　　处：《中华肝胆外科杂志》2023年第1期38-42,共5页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨腹腔镜手术治疗复发性肝癌的安全性和疗效。方法回顾性分析湖南省人民医院2010年1月至2018年1月收治的58例复发性肝癌患者的临床资料,其中男性50例,女性8例,年龄28~78岁,年龄(53.0±10.8)岁。根据手术方式不同分为腹腔镜组(n=27)和开腹组(n=31),比较两组的手术时间、术中出血量、住院时间、术后通气时间、术后并发症和预后的差异。结果腹腔镜和开腹组的术中出血量分别为100.0(50.0,400.0)ml和300.0(100.0,500.0)ml、术后通气时间为(2.7±0.6)d和(3.3±0.6)d、住院时间为(14.8±3.8)d和(21.4±6.3)d,腹腔镜组均少于开腹组,差异有统计学意义(均P<0.05);两组手术时间分别为(243.4±27.2)min和(217.5±34.7)min,差异无统计学意义(t=0.59,P=0.344)。在胆漏、腹腔感染、出血、胸腔积液和肝性脑病等术后并发症方面,两组比较差异无统计学意义(均P>0.05);在无瘤生存期、术后1、3年生存率预后指标方面两组比较差异无统计学意义(均P>0.05)。结论腹腔镜手术治疗复发性肝癌安全可行,可达到与开腹手术相似效果,且手术并发症无明显增加,临床值得推广。Objective To study the efficacy and safety of laparoscopic surgery in treatment of recurrent hepatocellular carcinoma.Methods The clinical data of 58 patients with recurrent hepatocellular carcinoma who underwent surgical treatment from January 2010 to January 2018 at Hunan Provincial People’s Hospital were retrospectively analyzed.There were 50 males and 8 females,ranging in age from 28 to 78(53.0±10.8)years old.Patients were divided into laparoscopic group(n=27)and laparotomy group(n=31)according to different surgical procedures.The differences in operative time,intraoperative blood loss,hospital stay,postoperative anal exhaustion time,postoperative complications and prognosis between the two groups were compared.Results The intraoperative blood loss of laparoscopy group and laparotomy group were 100.0(50.0,400.0)ml vs 300.0(100.0,500.0)ml,the postoperative anal exhaustion time were(2.7±0.6)d vs(3.3±0.6)d,the hospital stay were(14.8±3.8)d vs(21.4±6.3)d,and these differences were statistically significant(all P<0.05).The operative time of the two groups were(243.4±27.2)min vs(217.5±34.7)min,with no statistical significance(t=0.59,P=0.344).There were no significant differences between the two groups in postoperative complications(bile leakage,abdominal infection,hemorrhage,pleural effusion and hepatic encephalopathy)(all P>0.05);thetumor free survival,1-year,and 3-year overall survival rates of the two groups were also not significantly different(both P>0.05).Conclusion Laparoscopic surgery is safe and effective in the treatment of recurrent hepatocellular carcinoma,and its prognosis is similar to laparotomy,its complications are not significantly increased,which is worthy of promotion in clinic.

关 键 词：肝肿瘤 复发性 腹腔镜肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]