Laparoscopic hepatectomy vs open hepatectomy for hepatocellular carcinoma / 中华普通外科杂志

ABSTRACT

Objective To evaluate the safety and feasibility of laparoscopic hepatectomy for hepatocellular carcinoma(HCC). Methods From January 2002 through December 2007,86 HCC cases were divided into laparoscopic hepatectomy group and open hepatectomy group.Clinical data were analyzed. Results There were 36 cases in LH group,and 50 cases in OH group.Significant differences were noticed in the length of incision,operative blood loss,food-taking time,postoperative hospital stays,and analgesic usage between the two groups (respectively t =-37.608、-2.396、-13.073、-4.283 、x2 = 35.765,all P＜0.05),in which LH group was superior to OH group.Differences appeared in ALT,AST,ALP,r-GT and LDH on post-op day 1,and 3.APTT,ALB response on the fifth day after operation were different in the two groups (separately t =-3.465,-3.236,-3.470,-6.812,-4.837 and-3.998,-2.894,-4.286,-7.887,-5.388,6.131,7.292; all P ＜0.05);ALT,AST,ALP,r-GT value on the fifth day post-operation,and T-BIL on the day 1,5 post-operation were different in two groups (separately t =-4.795,-2.155,-3.442,-4.194,-2.712,-1.600,all P ＜0.05),Meanwhile,as the results all showed that,injuries were all less severe in LH than OH group.There were no significant differences between the two groups in operative time,resection method,overall complications,1-year,3-year survival rate,disease free survival (t =-0.893,separately x2 =0.066,0.026,0.468,0.156,0.106,2.732,all P ＞0.05) while 3-year survival rate in LH group and OH group were 50.0%,25% respectively (x2=2.732,P = 0.098). Conclusion Laparoscopic hepatectomy was safe and feasible for treatment of HCC,and its short-term efficacy was better than open hepatectomy.Furthermore,laparoscopic hepatectomy had promising long-term effectiveness.