Efficacy of three dimensional visualization technique assisted hepatectomy for the treatment of primary liver cancer / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the clinical efficacy of three dimensional visualization technique assisted hepatectomy for the treatment of primary liver cancer.</p><p><b>METHODS</b>A total of 108 primary liver cancer patients who had been admitted to Zhujiang Hospital of Southern Medical University from September 2013 to December 2014 were assigned to three dimensional visualization technique assisted hepatectomy group (n = 55) and routine hepatectomy group (n = 53) according to different methods of hepatectomy. The observed variable in two groups as fellow the operative time, intraoperative blood loss, intraoperative blood transfusion, the change of postoperative liver function and biochemical indicators in 1, 3, 5 days, postoperative complication. The patients were followed up via-return visit or telephone.A student's t test was used to compare continuous parametric variables, and the Mann-Whitney U test was used to compare non-parametric or discrete variables, as appropriate. Categorical data were compared using the Chi-square test or Fisher's exact test.</p><p><b>RESULTS</b>In 3D group and routine hepatectomy group, the patients' intraoperative blood transfusion volume were 300 ml (200-600 ml) and 400 ml (300-700 ml) (χ² = -2.609, P = 0.009) respectively, intraoperative blood loss volume were 400 ml (250-600 ml) and 550 ml (400-800 ml) (χ² = -2.277, P = 0.023), the operative time were (247 ± 57) min and (262 ± 53) min (χ² = -1.787, P = 0.074), the deterioration of the mainly liver function indicators peak in routine hepatectomy group were higher than that in 3D group (P < 0.05). The ALT, AST, TBIL in 3D group were lower than that in routine group on postoperative day 1, 3, 5, respectively (χ² = -5.740- -0.692, all P < 0.05). The ALB in 3D group was higher than that in routine group on postoperative day 3, 5 ((33.0 ± 5.6) g/L vs. (31.2 ± 4.1) g/L, (36.7 ± 4.4) g/L vs. (34.7 ± 4.2) g/L) (t = 1.922-2.573, both P < 0.05). In 3D group and routine hepatectomy group, the incidence of postoperative complications were 10.9% and 30.1% (χ² = 6.185, P = 0.013), the length of postoperative hospital day were (12.6 ± 3.6) days and (14.4 ± 3.5) days (χ² = -3.384, P = 0.031), the positive rate of resection margin were 0 and 9.4% respectively (Fisher test P = 0.026), the 1-year tumor recurrence rate were 22.2% and 37.5% (P > 0.05), 1-year survival rate was 82.2% and 77.5% (P > 0.05). No perioperative mortality was occured in the two groups.</p><p><b>CONCLUSION</b>Three dimensional visualization technique assisted hepatectomy for the treatment of primary liver cancer could reduce surgical injury, lower the rate of postoperative complications, improve the safety and the efficacy of the operation and achieve a good prognosis.</p>