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Objective To evaluate total laparoscopic left hemihepatectomy vs open procedures for operable left hepatic lesions.Methods We retrospectively analyzed the clinical data of laparoscopic and open hepatectomy in 40 patients with left hepatic disease in Huanshan People's Hospital between January 2016 and January 2018.Among them,laparoscopic hepatectomy was performed in 24 cases,open liver resection in 16 cases.Results The postoperative fasting time,postoperative analgesic usage and length of postoperative hospital stay were all significantly different in favor of laparoscopic group (t =4.158,x2 =9.184,t =2.174,all P ＜ 0.05),while,the operative time,intraoperative blood loss,incidence of postoperative complications and the total hospitalization expense showed no statistical difference (t =0.752,t =1.186,x2 =0.000,t =0.925,all P ＞ 0.05).Conclusion Laparoscopic left liver resection is a minimally invasive,safe and effective treatment for operable left liver lesions.
RESUMO
Objective To study the diagnosis and treatment of perforated gastric cancer(PGC). Methods The clinical data of 43 patients with PGC proved pathologically were analysed retrospectively; Results The diagnosis rate preoperatively was 30.2%(13 cases), misdiagonsis rate 69.8% (30 cases, including 2 misdiagonsed intraoperatively); 21 underwent simple suture closure of the perforation, among whom, 4 died (19.1%), 8 had hematemesis and melanorragia (38.1%), 3 reperforation (1.4%) after operation; mean survival period was 5 months. 9 cases had palliative gastrectomy, 1 died, while 1 had hematemesis after operation; mean survival period 18 months. 13 cases had radical gastrectomy, none of them had postoperative complication or death, mean survival period 27 months, 3 surrived for 5 years（23.1%）. 2 delyed diagnosis underwent simple suture closure at first, but had extensive metastasis at reoperation. Conclusions Comprehensive analysis of clcnical data made before operation and attenton paid to the signs of PGC during operation can enhance the diagnosis rate of PGC. Simple suture closure of the perforation has more complications, and the survival time is shorter . Once PGC gastric cancer is diagnosed , radical or palliative gastrectomy should be performed.