腹腔镜肝切除术治疗Ⅷ段肝细胞癌的围手术期安全性及可行性分析

肝癌电子杂志 ›› 2022, Vol. 9 ›› Issue (3): 7-11.

腹腔镜肝切除术治疗Ⅷ段肝细胞癌的围手术期安全性及可行性分析

宋增福, 赵亮, 徐海涛, 赵浩然, 王鹏, 王云峰, 张玉宝^*

哈尔滨医科大学附属肿瘤医院肝胆胰外科,黑龙江哈尔滨 150081

收稿日期:2022-07-04 出版日期:2022-09-30 发布日期:2022-10-27
通讯作者: ^*张玉宝,E-mail：zyb88077@sina.com
基金资助:
中国博士后科学基金面上项目（2019M661300）; 哈尔滨医科大学附属肿瘤医院海燕科研基金（JJMS2021-01）

Perioperative safety and feasibility analysis of laparoscopic hepatectomy ofⅧ segment hepatocellular carcinoma

Song Zengfu, Zhao Liang, Xu Haitao, Zhao Haoran, Wang Peng, Wang Yunfeng, Zhang Yubao^*

Department of Hepatobiliary and Pancreatic Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang, China

Received:2022-07-04 Online:2022-09-30 Published:2022-10-27

摘要/Abstract

摘要： 目的探讨腹腔镜肝切除术治疗Ⅷ段肝细胞癌的围手术期安全性及可行性。
方法：回顾性分析哈尔滨医科大学附属肿瘤医院2019年1月至2022年5月实施肝切除术的48例Ⅷ段肝细胞癌患者的临床资料,其中27例患者采用开腹肝切除术（开腹组）,21例患者采用腹腔镜肝切除术（腹腔镜组）。比较两组患者一般临床资料、手术指标及术后观察指标。
结果：两组患者一般临床资料比较差异均无统计学意义（P均>0.05）;两组患者手术时间、术中出血量、术中输血率、肿瘤切缘距离差异均无统计学意义（P均>0.05）;两组患者术后第1、3、5天肝功能指标、术后并发症发生率、引流管拔除时间及术后住院时间差异均无统计学意义（P均>0.05）。腹腔镜组患者肝门阻断时间长于开腹组患者[（48.0±14.8）min比（38.5±13.1）min,P<0.05],术后进食时间、下床活动时间短于开腹组[（1.6±0.7）d比（2.2 ± 0.6）d,（2.0 ± 0.7）比（2.4 ± 0.5）d,P均<0.05]。
结论：腹腔镜肝切除术治疗Ⅷ段肝细胞癌微创优势明显,术后能早进食、早下床活动,且不增加并发症的发生。经过腹腔镜手术经验积累后,Ⅷ段肝细胞癌实施腹腔镜肝切除术是安全的、可行的。

关键词: 腹腔镜肝切除术, Ⅷ段肝细胞癌, 围手术期, 安全性, 可行性

Abstract: Objective: To investigate the perioperative safety and feasibility of laparoscopic hepatectomy ofⅧ segment hepatocellular carcinoma.
Method: The data of 48 patients suffered fromⅧ segment hepatocellular carcinoma undergoing hepatectomy in Harbin Medical University Cancer Hospital from January 2019 to May 2022 were retrospectively analyzed, and they were divided into open group (27 cases) and laparoscopic group (21 cases). The basic clinical data, operative data and postoperative data of the two groups were compared.
Result: There were no significant differences in basic clinical data between the two groups (P>0.05). In intraoperative data, there were no significant differences in operative time, intraoperative blood loss, intraoperative blood transfusion rate and distance of tumor resection margin between the two groups (P>0.05). In postoperative data, there were no significant differences in liver function indexes of the 1st, 3rd and 5th day after surgery, postoperative complication rate, drainage tube removal time and postoperative hospital stay between the two groups (P>0.05). The blocking time of hepatic portal in the laparoscopic group was longer than that in the open group [(48.0±14.8)min vs. (38.5±13.1)min, P<0.05], and the time of taking food and out-of-bed mobilization after operation was shorter than that in the open group [(1.6±0.7)d vs. (2.2±0.6)d, (2.0±0.7)d vs. (2.4±0.5)d, P<0.05].
Conclusion: Laparoscopic hepatectomy ofⅧ segment hepatocellular carcinoma has obvious minimally invasive advantages, such as early postoperative food intake and early out-of-bed activity, without increasing the incidence of complications. After the accumulation of experience in laparoscopic surgery, laparoscopic hepatectomy ofⅧ segment hepatocellular carcinoma is safe and feasible.

Key words: Laparoscopic hepatectomy, Ⅷ segment hepatocellular carcinoma, Perioperative period, Safety, Feasibility

宋增福, 赵亮, 徐海涛, 赵浩然, 王鹏, 王云峰, 张玉宝. 腹腔镜肝切除术治疗Ⅷ段肝细胞癌的围手术期安全性及可行性分析[J]. 肝癌电子杂志, 2022, 9(3): 7-11.

Song Zengfu, Zhao Liang, Xu Haitao, Zhao Haoran, Wang Peng, Wang Yunfeng, Zhang Yubao. Perioperative safety and feasibility analysis of laparoscopic hepatectomy ofⅧ segment hepatocellular carcinoma[J]. Electronic Journal of Liver Tumor, 2022, 9(3): 7-11.

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