Clinical curative effect of laparoscopic left hepatectomy for primary hepatic carcinoma in 47 cases / 局解手术学杂志

ABSTRACT

Objective To evaluate the safety and feasibility of laparoscopic left hepatectomy in patients with primary hepatic carcinoma. Methods Retrospective analysis was conducted in clinical data of left hepatectomy from 2007 to 2014,including 47 cases of laparoscopic hepatectomy and 46 cases of open hepatectomy. The intraoperative and postoperative data of the two surgical methods were compared to evalu-ate whether laparoscopic left hepatectomy is safe and feasible. Results The tumor size were bigger in the open hepatectomy [(56. 57 ± 24. 56) mm vs. (64. 11 ± 33. 39) mm,P=0. 218]. The laparoscopic left hepatectomy resulted in shorter operation time [(217. 53 ± 60. 22) min vs.(306.80±119.91)min],andtherewasasignificantlydifference(P<0.05).Theintraoperativebloodlosswerelesserinthelaparo-scopic left hepatectomy [(350. 21 ± 197. 98) mL vs. (556. 74 ± 471. 41) mL],and there was a significantly difference (P<0. 05). The lap-aroscopic left hepatectomy had a smaller intraoperative blood transfusion rate (12. 8% vs. 32. 6%,P<0. 05). The length of ICU stay,time for gastroentestinal function recovery, postopetative hospital stay were shorter than those of open left hepatectomy (P<0. 05). There was no significant difference of postoperative complication rate between them (14. 9% vs. 23. 9%,P=0. 271). The survival rates of 1-and 3-year after operation in patients with laparoscopic left hepatectomy were 91. 5% and 83. 0% respectively,while 84. 8% and 76. 1% in patients un-derwent open hepatectomy. The tumor-free survival rates 1-and 3-year after operation were 74. 5% and 59. 6% in patients with laparoscopic left hepatectomy respectively,while 65. 2% and 54. 3% in patients underwent open hepatectomy. Conclusion Laparoscopic left hepatectomy for primary hepatic carcinoma is safe and feasible. Laparoscopic left hepatectomy could be a consideration as the standard surgical methods for hepatic carcinoma.