Extrathecal vs. intrathecal approach of Glisson's pedicle in laparoscopic resection of hepatocellular carcinoma: a propensity score matched analysis
10.3760/cma.j.cn113855-20221213-00775
- VernacularTitle:Glisson蒂鞘外法和鞘内法在腹腔镜肝细胞癌切除术中的倾向性评分匹配研究
- Author:
Hanyin HONG
1
;
Weifeng LAN
;
Yongbiao CHEN
;
Zhijian CHEN
;
Xiaobin CHI
;
Jianwei CHEN
;
Jianda YU
Author Information
1. 福建医科大学福总临床医学院，福州 350025
- Keywords:
Carcinoma ,hepatocellular;
Hepatectomy;
Glisson Pedicle;
Laparoscopy
- From:
Chinese Journal of General Surgery
2023;38(10):760-764
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate extrathecal vs. intrathecal approach of Glisson's pedicle in laparoscopic hepatectomy of hepatocellular carcinoma (HCC). Methods:Clinical data of 96 HCC patients receiving laparoscopic hepatectomy at the Department of Hepatobiliary Surgery, the 900 Hospital of the United Logistics Force from Jan 2019 to Jun 2022 were retrospectively analyzed. Thrity-six cases were treated with extrathecal approach of Glisson's pedicle and 60 cases were by intrathecal approach.All those 60 undergoing intrathecal approach cases were matched by 1∶1 propensity score matching, and the caliper value was 0.02. The duration of surgery, blocking-time of hepatoduodenal ligament, intraoperative blood loss, indexes of the liver function and the prothrombin time on the 1st day of the postoperative period, rate of the postoperative complications, postoperative hospital stay, postoperative survival and recurrence were compared between the two groups.Results:After propensity score matching, 32 cases in each group were identified. The operation time of the extrathecal group was shorter than that of the intrathecal group [(207.5±77.4) minutes vs. (248.6±74.7) minutes, P=0.03], the intraoperative bleeding volume was less than that of the intrathecal group [(150.0(100.0, 300.0) ml vs. 250.0(150.0, 587.5) ml, P=0.01], and the albumin level was higher on the 1st day after the surgery [(36.5±3.2) g/L vs. (34.3±3.2) g/L, P<0.01]. There was no statistically significant difference in postoperative liver function, coagulation, complications, hospitalization time, all over survival rate between the two groups (all P>0.05). Conclusion:Extrathecal approach for Glisson's pedicle is safe and feasible in laparoscopic hepatectomy for HCC, with simpler surgical procedure, less intraoperative trauma.
