腹腔镜下左半肝切除术治疗原发性肝癌的临床疗效及安全性

摘要

Objective:To investigate the clinical effect and safety of laparoscopic left hepatectomy for primary hepatic carcino -ma (PHC).Methods:A total of 64 patients with PHC were recruited and divided into research group (28 cases) and control group (36 cases).The patients in research group received laparoscopic left hepatectomy ,while the patients in control group received open left hep-atectomy .The operation time ,intraoperative blood loss ,postoperative ICU time ,gastrointestinal function recovery time ,postoperative hos-pitalization time and the postoperative complication incidence of liver failure ,bile leakage,ascites and air embolism were compared be-tween two groups .The indexes of postoperative survival time and recurrence rate were compared between two groups after one -year fol-low-up.Results:The operation time ,operation bleeding volume ,postoperative ICU time ,gastrointestinal function recovery time and post-operative hospitalization time of research group were lower than those of control group (P<0.05).The postoperative complication rates were not different between two groups (P>0.05).The indexes of postoperative survival time and recurrence rate after one -year follow-up were not different between two groups (P>0.05).Conclusions:Laparoscopic left hepatectomy for the treatment of PHC is of good clinical effect and safety with good prognoses .%目的:探讨腹腔镜下左半肝切除术治疗原发性肝癌的临床疗效及安全性.方法:选择64例手术治疗的原发性肝癌患者,分为研究组(n=28,行腹腔镜下左半肝切除术)与对照组(n=36,行常规开腹肝癌切除术).比较两组手术时间、术中出血量、术后ICU时间、术后胃肠功能恢复时间、术后住院时间等临床指标,以及肝功能衰竭、胆漏、腹水、气体栓塞等术后并发症.观察术后生存时间及术后1年肿瘤复发率.结果:研究组手术时间、术中出血量、术后ICU时间、术后胃肠功能恢复时间、术后住院时间等指标均显著低于对照组(P<0.05);两组术后并发症发生率差异无统计学意义(P>0.05).随访1年,术后生存时间及术后肿瘤复发率差异亦无统计学意义(P>0.05).结论:腹腔镜下左半肝切除术治疗原发性肝癌临床疗效显著,手术安全性高,且预后结局较理想,具有良好的临床治疗价值.