A clinical study on laparoscopic hepatic vein-guided anatomical hepatectomy for hepatocellular carcinoma
10.3760/cma.j.cn113884-20191122-00381
- VernacularTitle:腹腔镜下肝静脉导向解剖性肝切除术治疗肝细胞癌的临床研究
- Author:
Kexi LIAO
1
;
Li CAO
;
Deng HUANG
;
Tiange SUN
;
Xuesong LI
;
Xiaojun WANG
;
Jianwei LI
;
Jian CHEN
;
Shuguo ZHENG
Author Information
1. 陆军军医大学西南医院肝胆外科，重庆 400038
- From:
Chinese Journal of Hepatobiliary Surgery
2020;26(5):339-344
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the use of laparoscopic hepatic vein guided anatomic hepatectomy in the treatment of hepatocellular carcinoma.Methods:The clinical and follow-up data of 62 patients who underwent laparoscopic anatomic hepatectomy at the Department of Hepatobiliary Surgery of Southwest Hospital of the Army Medical University from January 2015 to February 2018 and met the inclusion criteria of the study were retrospectively analyzed. The operation procedure as to whether the main hepatic vein was exposed or not was determined. The patients were divided into the hepatic vein-oriented hepatectomy (HVOH) group when the main hepatic vein was exposed, and the traditional anatomic hepatectomy (TAH) group when the main hepatic vein was not shown. The perioperative and follow-up data of the two methods were compared.Results:A total of 31 cases were included in the HVOH group, there were 28 males and 3 females, age ranged from 29.0-70.0 (49.9±11.2) years. A total of 31 cases were included in the TAH group, there were 27 males and 4 females, age ranged from 22.0-73.0 (51.4±12.1) years. There were no significant differences in operation time, intraoperative blood loss, postoperative hospital stay, intraoperative conversion to open, and perioperative blood transfusion rates between the two groups ( P>0.05). The incidence of postoperative complication was significantly lower in the HVOH group than in the TAH group [9.7% (3/31) vs. 32.2% (10/31)] ( P<0.05), but no serious complications occurred (Clavein Level IV) in this study. The one-year tumor-free survival rate in the HVOH group was significantly higher than that in the TAH group (77.4% vs. 51.6%), ( P<0.05). There were no significant differences in the 1- and 3-year overall survival rates and tumor-free survival rates between the two groups ( P>0.05). Conclusion:Laparoscopic hepatic vein-guided anatomic hepatectomy for hepatocellular carcinoma had the potential advantages in reducing the perioperative complication rate, and enhanced the early tumor-free survival rates.
