Efficacy of laparoscopic liver resection for patients with hepatocellular carcinoma at complicated region

doi:10.3877/cma.j.issn.2095-3232.2018.01.013

Abstract

Abstract:

Objective

To explore the efficacy of laparoscopic liver resection (LLR) in the treatment of patients with hepatocellular carcinoma (HCC) at complicated region.

Methods

Clinical data of 89 patients with HCC at complicated region treated in West China Hospital of Sichuan University between February 2015 and February 2017 were analyzed retrospectively. These patients were divided into LLR group and open liver resection group (OLR group) according to different operative procedures. There were 36 patients in LLR group, including 27 males and 9 females, with an average age of (54±13) years old. There were 53 patients in OLR group, including 44 males and9 females, with an average age of (52±11) years old. The informed consents of all patients were obtained and the local ethical committee approval was received. Perioperative conditions and postoperative quality of life score in both groups were compared using t test or Kruskal-Wallis rank sum test, and survival analysis was conducted using Kaplan-Meier test and Log-rank test.

Results

The length of operation was (268±89) min in LLR group, significantly longer than (210±74) min in OLR group (t=3.365, P<0.05). The postoperative length of hospital stay was (6.2±1.2) d in LLR group, significantly shorter than (7.2±2.3) din OLR group (t=-2.347, P<0.05). The operation expenses was (19.1±9.3) thousand RMB in LLR group, which was significantly higher than (6.1±1.7) thousand RMB in OLR group (t=10.425, P<0.05). The score of daily activity, accessory symptoms of HCC and score of quality of life were (25±4), (64±7) and (151±20) points in LLR group, significantly higher than (23±3), (60±7) and (144±9) points in OLR group, respectively (t=2.278, 2.375, 2.720; P<0.05). The overall survival, disease-free survival were respectively 93.0%, 78.0% in OLR group, and respectively 97.0%, 79.0% in LLR group, where no significant difference was observed (χ²=0.276, 0.029; P>0.05).

Conclusions

Compared with OLR, LLR can obviously shorten the length of hospital stay and improve the postoperative quality of life for patients with hepatocellular carcinoma (HCC) at complicated region. It is safe and feasible.

Key words: Liver neoplasms, Laparoscopes, Hepatectomy

Qinqin Liu, Yifan Hu, Fei Liu, Yonggang Wei, Bo Li. Efficacy of laparoscopic liver resection for patients with hepatocellular carcinoma at complicated region[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2018, 07(01): 48-52.

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References 20

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组别	例数	年龄（岁，±s）	性别（例）		BMI（kg/m²，±s）	肿瘤直径（cm，±s）	肿瘤位置（例）
组别	例数	年龄（岁，±s）	男	女	BMI（kg/m²，±s）	肿瘤直径（cm，±s）	I段	Ⅳa段	Ⅶ段	Ⅷ段
LLR组	36	54±13	27	9	23±3	4.2±2.3	1	6	17	12
OLR组	53	52±11	44	9	24±3	4.3±1.9	3	2	20	28
统计值	?	t=0.928	χ²=0.854		t=-1.478	t=-0.290	χ²=6.698
P值	?	>0.05	>0.05		>0.05	>0.05	>0.05

组别	例数	年龄（岁，±s）	性别（例）		BMI（kg/m²，±s）	肿瘤直径（cm，±s）	肿瘤位置（例）
组别	例数	年龄（岁，±s）	男	女	BMI（kg/m²，±s）	肿瘤直径（cm，±s）	I段	Ⅳa段	Ⅶ段	Ⅷ段
LLR组	36	54±13	27	9	23±3	4.2±2.3	1	6	17	12
OLR组	53	52±11	44	9	24±3	4.3±1.9	3	2	20	28
统计值	?	t=0.928	χ²=0.854		t=-1.478	t=-0.290	χ²=6.698
P值	?	>0.05	>0.05		>0.05	>0.05	>0.05

组别	例数	手术时间（min，±s）	术中出血量[ml，M(Q_R）]	术中输血（例）	术后1 d引流量[ml，M(Q_R）]	术后引流管拔除时间（d，±s）	术后排气时间[d，M(Q_R）]	术后住院时间（d，±s）	并发症（例）	手术费用（万元，±s）
LLR组	36	268±89	200（100～300）	2	200（50～350）	6.8±3.9	5（1～9）	6.2±1.2	14	1.91±0.93
OLR组	53	210±74	200（100～300）	2	200（105～295）	5.6±1.6	6（1～11）	7.2±2.3	18	0.61±0.17
统计值	?	t=3.365	Z=-0.337	χ²=0.156	Z=-1.497	t=1.926	Z=-0.932	t=-2.347	χ²=0.226	t=10.425
P值	?	<0.05	>0.05	>0.05	>0.05	>0.05	>0.05	<0.05	>0.05	<0.05

组别	例数	手术时间（min，±s）	术中出血量[ml，M(Q_R）]	术中输血（例）	术后1 d引流量[ml，M(Q_R）]	术后引流管拔除时间（d，±s）	术后排气时间[d，M(Q_R）]	术后住院时间（d，±s）	并发症（例）	手术费用（万元，±s）
LLR组	36	268±89	200（100～300）	2	200（50～350）	6.8±3.9	5（1～9）	6.2±1.2	14	1.91±0.93
OLR组	53	210±74	200（100～300）	2	200（105～295）	5.6±1.6	6（1～11）	7.2±2.3	18	0.61±0.17
统计值	?	t=3.365	Z=-0.337	χ²=0.156	Z=-1.497	t=1.926	Z=-0.932	t=-2.347	χ²=0.226	t=10.425
P值	?	<0.05	>0.05	>0.05	>0.05	>0.05	>0.05	<0.05	>0.05	<0.05

组别	例数	日常活动评分	社交/家庭生活评分	情绪状况评分	活动能力评分	肝癌附加症状评分	总评分
LLR组	36	25±4	22±4	20±4	20±6	64±7	151±20
OLR组	53	23±3	21±2	20±1	20±3	60±7	144±90
t值	?	2.278	2.183	0.786	1.317	2.375	2.720
P值	?	<0.05	>0.05	>0.05	>0.05	<0.05	<0.05

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