腹腔镜肝切除术治疗多发性中期肝癌的疗效分析

摘要/Abstract

摘要： 目的：与开腹肝切除术对比,评价腹腔镜肝切除术治疗多发性中期肝癌的安全性和有效性。
方法：回顾性分析2015年4月至2018年10月进行肝切除术的多发性中期肝癌患者217例。其中75例患者采用腹腔镜肝切除术（腹腔镜组）,142例患者采用开腹肝切除术（开腹组）。对两组患者进行倾向评分匹配（propensity score matching,PSM）后,比较两组患者围手术期结果和长期生存情况。
结果：经PSM后每组各72例患者。与开腹组患者比较,腹腔镜组患者手术时间更长,术中出血量更少,并发症发生率更低,术后住院时间更短,且差异均有统计学意义（P<0.05）。而两组患者总生存率、无瘤生存率差异均无统计学意义（P=0.827、0.694）。
结论：腹腔镜肝切除术对部分可切除的多发性中期肝癌患者安全、可行。

关键词: 腹腔镜, 肝切除术, 多发性中期肝癌, 围手术期, 预后

Abstract: Objective: To assess the safety and efficacy of laparoscopic versus open liver resection for patients with resectable multiple hepatocellular carcinomas (HCCs) beyond Milan criteria.
Methods: A total of 217 patients met the inclusion and exclusion criteria were enrolled in this study, and there were 75 patients in the laparoscopic liver resection group (LLR) and 142 patients in the open liver resection group (OLR). 1:1 propensity score matching (PSM) was performed to calculate short- and long-term outcomes between the two groups.
Results: 72 patients with well-balanced baselines were included into each group. LLR had longer operative time (median, 237.5 min vs. 210 min, P=0.024), less intraoperative blood loss (median, 200 ml vs. 350 ml, P=0.005), less complications (P=0.035), and equivalent survival outcomes (OS, P=0.827; RFS, P=0.694) when compared with OLR.
Conclusion: LLR could be effective for some selected patients with resectable multiple HCCs beyond Milan criteria, and it had superior perioperative outcomes and similar oncological outcomes when compared with OLR.

Key words: Laparoscope, Hepatectomy, Resectable multiple hepatocellular carcinoma, Perioperation, Prognosis

彭榆富, 刘非, 李波, 魏永刚. 腹腔镜肝切除术治疗多发性中期肝癌的疗效分析[J]. 肝癌电子杂志, 2021, 8(4): 13-16.

Peng Yufu, Liu Fei, Li Bo, Wei Yonggang. Laparoscopic versus open liver resection for resectable multiple hepatocellular carcinomas beyond Milan criteria[J]. Electronic Journal of Liver Tumor, 2021, 8(4): 13-16.

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