摘要
目的比较肝左外叶单孔腹腔镜切除术(SPLS)与传统多孔腹腔镜切除术(MPLS)治疗肝细胞癌(HCC)的安全性和可行性。方法抽取2017年12月至2019年12月于新乡市中心医院接受腹腔镜肝左外叶切除术的HCC患者180例, 依据随机数字法分为MPLS组(90例)与SPLS组(90例)。按有无肝硬化分为肝硬化组110例, 其中行SPLS术53例, 行MPLS术57例;非肝硬化组70例, 其中行SPLS术37例, 行MPLS术33例。观察指标为手术时间, 术中失血量、肿瘤长径、住院时间及并发症。结果 SPLS组的手术时间为(81.57±11.26)min, 术中失血量为(63.80±20.47)ml, 肿瘤长径为(2.48±0.74)cm, 住院时间为(4.82±0.73)d, 与MPLS组比较, P>0.05。肝硬化组中SPLS组手术时间为(70.61±17.41)min, 术中失血量为(61.10±11.40)ml, 肿瘤长径为(3.18±1.10)cm, 住院时间为(5.07±1.19)d, 与MPLS组比较, P>0.05。非肝硬化组中SPLS组手术时间为(77.03±10.89)min, 术中失血量为(59.62±12.51)ml, 肿瘤直径为(3.61±1.26)cm, 住院时间为(5.79±0.69)d, 与MPLS组比较差异未见统计学意义(P>0.05)。SPLS组和MPLS组发生各级并发症的例数对比无统计学差异(P>0.05)。肝硬化组、非肝硬化组组内对比, 发生各级并发症的例数均无统计学差异(P>0.05)。结论 SPLS是治疗左侧肝细胞癌可行且安全的手术方法。
Objective To compare the safety and feasibility of single-port laparoscopic surgery(SPLS)and multi-port laparoscopic surgery(MPLS)of left lateral lobe of liver in the treatment of hepatocellular carcinoma(HCC).Methods A total of 180 patients who received left laparoscopic hepatectomy in Xinxiang Central Hospital from December 2017 to December 2019 were selected.They were divided into MPLS group(90 cases)and SPLS group(90 cases)according to random number method.According to the presence or absence of cirrhosis,the 180 HCC patients were divided into cirrhosis group(180 cases,including 53 cases undergoing SPLS and 57 cases undergoing MPLS)and non cirrhosis group(70 cases,including 37 cases undergoing SPLS and 33 cases undergoing MPLS).The main outcome measures were operation time,intraoperative blood loss,tumor long diameter,length of hospital stay and complication.Results The average operation time,blood loss,tumor long diameter and hospital stay of SPLS group were(81.57±11.26)min,(63.80±20.47)ml,(2.48±0.74)cm and(4.82±0.73)days,respectively,compared with that of MPLS group,P>0.05.In cirrhosis group,the average operation time of SPLS was(70.61±17.41)min,intraoperative blood loss was(61.10±11.40)ml,tumor long diameter was(3.18±1.10)cm,hospital stay was(5.07±1.19)days,there was no significant difference in comparison with MPLS group(P>0.05).In non cirrhotic group,the average operation time,intraoperative blood loss,tumor long diameter and hospital stay of SPLS group were(77.03±10.89)min,(59.62±12.51)ml,(3.61±1.26)cm and(5.79±0.69)days,respectively,compared with that of MPLS group,P>0.05.There was no significant difference in the number of complications at different grades between SPLS group and MPLS group(P>0.05).And there was no significant difference in intra-group comparison on the number of complications at differenr grades in cirrhotic group and non cirrhotic group(P>0.05).Conclusions SPLS is a feasible and safe method for the treatment of left hepatocellular carcinoma.
作者
杨小伟
赵宏峰
刘佳林
Yang Xiaowei;Zhao Hongfeng;Liu Jialin(Department of Oncology,Xinxiang Central Hospital,the Fourth Clinical College of Xinxiang Medical University,Xinxiang 453000,China)
出处
《中国实用医刊》
2021年第20期4-7,共4页
Chinese Journal of Practical Medicine
关键词
肝细胞癌
腹腔镜肝左外叶切除术
肝硬化
Hepatocellular carcinoma
Laparoscopic left lateral hepatectomy
Cirrhosis
