The comparative analysis of clinical curative effect of laparoscopic hepatectomy and open resection for hepatic tumor

毛岸荣; 潘　奇; 赵一鸣

doi:10.19401/j.cnki.1007-3639.2017.04.009

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The comparative analysis of clinical curative effect of laparoscopic hepatectomy and open resection for hepatic tumor

更新时间：2025-12-31

- The comparative analysis of clinical curative effect of laparoscopic hepatectomy and open resection for hepatic tumor
- China Oncology Vol. 27, Issue 4, Pages: 293-296(2017)
- 作者机构：
  
  复旦大学附属肿瘤医院肝脏外科，复旦大学上海医学院肿瘤学系,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2017.04.009
  CLC：
- Published Online：05 May 2017，
  
  Published：05 May 2017
- 稿件说明：
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毛岸荣,潘　奇,赵一鸣,等. 腹腔镜与开腹肝肿瘤切除术临床疗效的对比分析[J]. 中国癌症杂志, 2017, 27(4): 293-296.

毛岸荣, 潘　奇, 赵一鸣. The comparative analysis of clinical curative effect of laparoscopic hepatectomy and open resection for hepatic tumor[J]. China Oncology, 2017, 27(4): 293-296.
毛岸荣,潘　奇,赵一鸣,等. 腹腔镜与开腹肝肿瘤切除术临床疗效的对比分析[J]. 中国癌症杂志, 2017, 27(4): 293-296. DOI： 10.19401/j.cnki.1007-3639.2017.04.009.

毛岸荣, 潘　奇, 赵一鸣. The comparative analysis of clinical curative effect of laparoscopic hepatectomy and open resection for hepatic tumor[J]. China Oncology, 2017, 27(4): 293-296. DOI： 10.19401/j.cnki.1007-3639.2017.04.009.

摘要

背景与目的：随着腹腔镜技术在肝脏外科中的应用日渐广泛，腹腔镜肝切除的安全性和可行性逐步得到了认可，该研究旨在探讨腹腔镜肝肿瘤切除术与开腹肝肿瘤切除术的可行性与临床疗效。方法：回顾性分析复旦大学附属肿瘤医院2015年3月—2016年3月37例接受腹腔镜肝肿瘤切除术与74例接受传统开腹肝肿瘤切除术患者的临床资料，计量资料采用Wilcoxon秩和检验，统计值为Z，计数资料采用Fisher精确概率检验；分析手术时间、术中出血量、手术后胃肠道恢复时间、手术后引流管拔管时间、住院时间、术后并发症和住院费用等临床资料。腹腔镜组：男性20例，女性17例，年龄18~76岁(中位年龄55岁)；开腹组：男性42例，女性32例，年龄26~74岁(中位年龄54岁)。切肝方式为超声刀+单极电凝，结合腹腔镜下切割缝合器。腹腔镜组的手术方式包括：局部切除13例；行肝段或肝叶解剖性切除24例。开腹组的手术方式包括：局部切除33例；行肝段或肝叶解剖性切除41例。结果：手术平均用时：腹腔镜组为149 min(40~204 min)，开腹组为142 min(45~190 min)。术中出血量：腹腔镜组为220 mL(30~570 mL)，开腹组为360 mL(90~970 mL)。平均住院时间：腹腔镜组为4.9 d(3.0~6.0 d)，开腹组为6.8 d(5.0~9.0 d)。手术后胃肠道恢复平均时间：腹腔镜组为1.1 d，开腹组为2.3 d。手术后引流管拔管时间：腹腔镜组为3.1 d，开腹组为5.8 d。平均住院费用：腹腔镜组为38 760元，开腹组为39 145元。手术后并发症：腹腔镜组为8.1％(3/37)，开腹组为9.5％(7/74)。结论：腹腔镜肝切除术是一种安全、有效、微创的手术，可安全用于局部、肝段及半肝切除术，值得推广使用。

Abstract

Background and purpose: With the application of laparoscopy in the liver surgery increasingly widely used

the safety and feasibility of laparoscopic liver resection is gaining recognition gradually. This study aimed to explore the laparoscopic liver resection for the tumor and the feasibility of open liver tumor resection and clinical curative effect. Methods: We retrospectively analysed the clinical data from 37 cases of laparoscopic hepatectomy and 74 patients with open liver resection from Mar. 2015 to Mar. 2016. Measurement data by covariance analysis were obtained

and comparison between groups were made using independent sample with Wilcoxon rank test and statistical value of Z. We collected data including operation time

intra-operative blood loss

post-operative recovery time of gastrointestinal tract

surgical drainage tube after extubation time

length of hospital stay

postoperative complications

hospitalization expenses and other clinical data. Laparoscopic group had 20 males and 17 female aged 18 to 76 (median age 55). Open group had 42 males and 32 females aged 26 to 74 (median age 54). The hepatectomy included ultrasonic knife + unipolar electric coagulation

combined with laparoscopic incision suture. Surgery procedures included 13 cases of local excision in laparoscopic group and 24 cases of liver segment or lobe anatomical resection. Open group had 33 cases of local excision and 41 cases of liver segment or lobe anatomical resection. Results: The average duration of laparoscopic hepatectomy was 149 min (40-204 min). The average duration of open hepatectomy was 142 min (45-190 min). The average intra-operative blood loss was 220 mL (30-570 mL) in laparoscopic group and 360 mL (90-970 mL) in open group. The average length of hospital stay was 4.9 d (3-6 d) in laparoscopic group and 6.8 d (5-9 d) in open group. Gastrointestinal average recovery time was 1.1 days in laparoscopic group and 2.3 days in open group. The average hospitalization expenses were 38 760 yuan in laparoscopic group and 39 145 yuan in open group. Conclusion: Laparoscopic hepatectomy is a safe

effective and minimally invasive surgery

can be safely used in local

liver segment and half liver resection

worthy of promotion.

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