目的 探讨腹腔镜肝切除术在肝癌治疗中的临床意义.方法 手术治疗的肝癌患者60例,根据手术方式分为腹腔镜肝切除术(laparoscopic hepatectomy,LH)和开腹肝切除(open hepatectomy,OH),每组各30例.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、1年复发率、总体复发率、无瘤生存期及总体生存期.结果 LH组术中出血量[(326.67±45.53)ml比(458.33±30.14)ml]、术后住院时间[(7.89±2.54)天比(11.97±3.38)天]、术后并发症发生率(23.33%比63.33%)优于OH组,差异有统计学意义(P<0.05);手术时间、1年复发率、总体复发率、无瘤生存期及总体生存期比较,差异无统计学意义(P>0.05).结论 LH术中出血少、术后住院时间短,术后并发症发生率低,其远期治疗效果与OH比较无明显差异.%Objective To investigate clinical significance of standardized treatment for hepatolithiasis.Methods A total of 130 patients received surgical treatment for hepatolithiasis.They were divided into the standardized treatment group (71 cases) and control group (59 cases) according to the principle of treatment and surgical methods.Postoperative complications (bile leakage, bleed, and hypohepatia) and therapeutic effects (incidence of residual stone, recurrent stone, and the second operation) were compared between the groups.Results Compare to OH group,LH group was better in intraoperative bleeding loss[(326.67±45.53)ml vs(458.33±30.14)ml],postoperative hospitalization days[(326.67±45.53)ml vs(458.33±30.14)ml] and postoperative complications rates(23.33% vs 63.33%),the differences were statistical significance(P<0.05).There was no statistically significant differences in the operation time,1-year recurrence rate,overall recurrence rate,no tumor survival and overall survival between the two groups(P>0.05).Conclusion Standardized treatment may decrease the incidence rates of residual stone, recurrent stone and the second operation, which improves the therapeutic effect and prognosis of hepatolithiasis.
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