左侧入路降肝门板联合Glisson蒂横断式肝切除术在肝脏肿瘤中的应用价值  

Application value of left approach descending hepatic portal plate combined with Glisson pedicle transection hepatectomy in liver tumors

作　　者：游鲲 郭涛 陈素娟 李聪 杨沛 胡红强 YOU Kun;GUO Tao;CHEN Sujuan;LI Cong;YANG Pei;HU Hongqiang(Hepatobiliary and Pancreatic Surgery Department,Emeishan 614200,China;Medical Oncology Department,Foguang Hospital of Emei Mountain,Emeishan 614200,China)

机构地区：[1]峨眉山佛光医院肝胆胰外科,四川峨眉山614200 [2]峨眉山佛光医院肿瘤内科,四川峨眉山614200

出　　处：《临床医学研究与实践》2024年第21期37-41,共5页Clinical Research and Practice

基　　金：乐山市2021年重点科技计划项目(No.21SZD138)。

摘　　要：目的探讨左侧入路降肝门板联合Glisson蒂横断式肝切除术在肝脏肿瘤中的应用价值。方法选取2018年6月至2022年6月于我院行肝脏肿瘤手术的126例患者为研究对象,根据手术方式不同将其分为试验组(68例,左侧入路降肝门板联合Glisson蒂横断式肝切除术)和对照组(58例,传统解剖性肝切除手术)。比较两组的术中出血量、手术时长、肝功能指标、术后并发症发生情况及生存情况。结果试验组的术中出血量少于对照组(P<0.05);两组的手术时长比较,差异无统计学意义(P>0.05)。术后3、7 d,试验组的谷草转氨酶(AST)、谷丙转氨酶(ALT)水平低于对照组(P<0.05)。试验组的术后并发症总发生率低于对照组(P<0.05)。试验组和对照组的远期中位生存时间分别为22.0个月和17.0个月,差异无统计学意义(P=0.057);试验组和对照组的无瘤中位生存时间分别为20.0个月和17.0个月,差异无统计学意义(P=0.187)。结论左侧入路降肝门板联合Glisson蒂横断式肝切除术具有出血量少、肝损伤轻等优点,是治疗肝脏肿瘤安全、有效、可行的手术方法。Objective To explore the application value of left approach descending hepatic portal plate combined with Glisson pedicle transection hepatectomy in liver tumors.Methods A total of 126 patients who underwent liver tumors surgery in our hospital from June 2018 to June 2022 were selected as the research objects.According to different surgical methods,the patients were divided into experimental group(68 cases,left approach descending hepatic portal plate combined with Glisson pedicle transection hepatectomy)and control group(58 cases,traditional anatomical hepatectomy).The intraoperative blood loss,operation time,liver function indexes,postoperative complications and survival were compared between the two groups.Results The intraoperative blood loss in the experimental group was less than that in the control group(P<0.05);there was no significant difference in the operation time between the two groups(P>0.05).At 3,7 d after operation,the levels of aspartate transaminase(AST)and alanine aminotransferase(ALT)in the experimental group were lower than those in the control group(P<0.05).The total incidence of postoperative complications in the experimental group was lower than that in the control group(P<0.05).The long-term median survival time of the experimental group and the control group was 22.0 months and 17.0 months,respectively,and the difference was not statistically significant(P=0.057);the median tumor-free survival time of the experimental group and the control group was 20.0 months and 17.0 months,respectively,and the difference was not statistically significant(P=0.187).Conclusion The left approach descending hepatic portal plate combined with Glisson pedicle transection hepatectomy has the advantages of less bleeding and less liver injury,it is a safe,effective and feasible surgical method for the treatment of liver tumors.

关 键 词：肝脏肿瘤 Glisson蒂横断式 肝切除术 

分 类 号：R735.3[医药卫生—肿瘤]