腹腔镜治疗肝右叶癌的疗效分析

doi:10.3969/j.issn.1000-8535.2016.04.020

摘要/Abstract

摘要： 目的探讨腹腔镜治疗肝右叶癌的疗效。方法 2011年6月—2014年9月我院对78例肝右叶癌行手术治疗,其中18例行全腹腔镜肝癌切除术,60例行开腹肝癌切除术。比较两组患者的手术时间、术中出血量、术后住院时间、术后并发症发生率、术后一年生存率。结果腹腔镜组手术时间为(348.8±98.8)min,长于开放手术组,差异具有统计学意义(P<0.05);腹腔镜组术中出血量、术后住院时间、术后并发症发生率均少于开放手术组,相比差异具有统计学意义(P<0.05);两组患者术后1年复发率及生存率比较未见统计学意义(P>0.05)。结论腹腔镜治疗肝右叶癌手术难度大,但相比开腹手术,腹腔镜肝右叶癌切除术具有术中出血量少、术后住院时间短、术后并发症发生率低的优点。

关键词: 腹腔镜, 肝切除术, 肝右叶癌

Abstract: Objective To evaluate the clinical efficacy of laparoscopic treatment of carcinoma of the right lobe of the liver. Methods from June 2011 to September 2014 in our hospital 78 cases of liver cancer of right lobe underwent surgical treatment, including 18 cases of pure laparoscopic liver resection, 60 cases underwent open resection of hepatocellular carcinoma. Comparing the two groups of patients with operation time,intraoperative bleeding volume,postoperative hospitalization time, postoperative complication rat and one year survival rate. Results The operative time of laparoscopic group was 348.8±98.8 min, longer than the open surgery group, the difference has statistical significance (P<0.05); The intraoperative bleeding volume,postoperative hospitalization time,postoperative complication rate in the laparoscopic group was less than that of the open surgery group, the difference has statistical significance (P<0.05); Two groups of patients with postoperative 1 year survival rate and recurrence rate were not statistically significant (P>0.05). Conclusion Laparoscopic treatment of the liver cancer of the right lobe is difficult, but compared to open surgery, laparoscopic resection of the liver cancer of the right lobe has advantages of less bleeding, shorter postoperative hospitalization, lower postoperative complication rate.

Key words: Laparoscopy, Hepatectomy, Liver cancer of right lobe

敖平. 腹腔镜治疗肝右叶癌的疗效分析[J]. 广州医药, 2016, 47(4): 62-64.

Ao Ping. Clinical analysis of laparoscopic treatment of liver cancer of right lobe[J]. Guangzhou Medical Journal, 2016, 47(4): 62-64.

参考文献

[1] LAI Q, LERUT JP. Hepatocellular cancer: how to expand safely inclusion criteria for liver transplantation[J]. Curr Opin Organ Transplant,2014,19:229-34.
[2] GIOVANNI BLS, MAR COC, ROBERTO S, etal.Laparoscopic right hepatectomy for hepatocellular carcinoma in cirrhotic patient[J]. Hepatobiliary Surg Nutr,2015,4(6):436-438.
[3] 陈威,易永祥,张海斌,等. 3种评分系统预测肝移植短期预后的效果评价[J]. 中华肝胆外科杂志,2014,20(8): 557-561.
[4] WAYAND W, WOISETSCHLAGER R.Laparoscopic resection of liver metastasis[J]. Chirurg, 1993,64(3):195-197.
[5] ETTORRE GM, LEVI SANDRI GB. Laparoscopic approach for hepatocellular carcinoma: where is the limit?[J]. Chin J Cancer Res,2014,26:222-223.
[6] 江文枢, 卢榜裕,蔡小勇,等, 腹腔镜肝切除治疗原发性肝癌的探讨[J]. 中国内镜杂志,2007,13(12):1254-1256.
[7] LLOVET JM, BURROUGHS A, BRUIX J. Hepatocellular carcinoma[J]. Lancet, 2003,362:1907-1917.
[8] FARGES O, MALASSAGNE B, FLEJOU JF, et al. Risk of major liver resection in patients with underlying chronic liver disease: a reappraisal[J]. Ann Surg,1999,229:210-215.
[9] KANAZAWA A, TSUKAMOTO T, SHIMIZU S, et al. Impact of laparoscopic liver resection for hepatocellular carcinoma with F4-liver cirrhosis[J]. Surg Endosc,2013,27:2592-2597.
[10] 朱光辉,徐波,庄思敏.肝癌切除后并发症的原因及对策[J]. 广州医药,2003,34(1),20-21.
[11] 阮南宋. 61例肝癌切除术后合并症的临床分析[J]. 广州医药,1997,28(3),35-36.
[12] LAI EC, TANG CN, YANG GP, et al. Multimodality laparoscopic liver resection for hepatic malignancy-from conventional total laparoscopic approach to robot-assisted laparoscopic approach[J]. Int J Surg 2011,9:324-328.
[13] BUELL JF, CHERQUI D, GELLER DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008[J]. Ann Surg, 2009,250:825-830.
[14] WAKABAYASHI G, CHERQUI D, GELLER DA, et al. Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka[J]. Ann Surg,2015,261:619-629.
[15] VIBERT E,PERNICENI T,LEVARD H, et al. Laparoscopic liver resection[J]. Br J Surg,2006, 93(1):67-72.
[16] 韩亚飞,邰沁文,温浩,等. 腹腔镜与开腹肝左外叶切除术的比较[J]. 中国微创外科杂志, 2013,13(5):403-405.
[17] 张跃伟. 微创介入治疗肝癌对机体免疫功能影响的研究现状与展望[J]. 实用肝脏病杂志, 2014,17(3): 231-234.