Application value of extrathecal Glisson blood flow occlusion in the resection of primary liver cancer / 中国基层医药

ABSTRACT

Objective:To investigate the application value of extrathecal Glisson blood flow occlusion in the resection of primary liver cancer.Methods:74 patients with primary liver cancer who received treatment in Yuyao People's Hospital from January 2019 to January 2020 were included in this study. They were randomly assigned to undergo resection of the primary liver cancer with either extracorporeal Pringle maneuver (control group, n = 37) or extrathecal Glisson maneuver (observation group, n = 37). Surgery-related indexes, postoperative liver function and gastrointestinal function recovery, and complications were monitored in each group. Results:Blood flow occlusion time and hospital length of stay in the observation group were (25.10 ± 5.19) minutes and (12.45 ± 1.10) days, which were significantly shorter than those in the control group [(30.65 ± 8.54) minutes, (14.85 ± 1.28) days, t = 3.378, 8.650, both P < 0.05]. Volume of blood loss in the observation group was significantly less than that in the control group [(490.36 ± 120.19) mL vs. (655.58 ± 152.24) mL, t = 5.181, P < 0.05]. Intraoperative blood transfusion rate in the observation group was significantly lower than that in the control group [21.62% (8/37) vs. 45.95% (17/37), χ2 = 4.893, P < 0.05]. At 1, 3 and 7 days after surgery, aspartate aminotransferase level in the observation group was (240.36 ± 60.52) U/L, (145.69 ± 42.18) U/L and (60.13 ± 12.58) U/L, respectively, which was significantly lower than that in the control group [(350.21 ± 60.16) U/L, (212.53 ± 40.21) U/L, (103.65 ± 20.54) U/L, t = 7.930, 6.977 and 10.991, all P < 0.05]. At 1 and 7 days after surgery, alanine aminotransferase level in the observation group was (228.52 ± 65.28) U/L and (44.26 ± 12.85) U/L, respectively, which was significantly lower than that in the control group [(350.16 ± 68.58) U/L, (466.36 ± 40.29) U/L, t = 7.815 and 3.179, both P < 0.05]. At 1 and 7 days after surgery, total bilirubin level in the observation group was (28.58 ± 5.24) μmol/L and (20.30 ± 5.10) μmol/L, which was significantly lower than that in the control group [(43.32 ± 10.26) μmol/L, (26.08 ± 5.68) μmol/L, t = 7.783, 4.606, both P < 0.05]. At 1 day after surgery, albumin level in the observation group was significantly lower than that in the control group [(34.65 ± 2.42) g/L vs. (31.12 ± 2.23) g/L, t = 6.525, P < 0.05). The time to recovery of bowel sounds, the time to the first exhaust, and the time to defecation in the observation group were (14.28 ± 2.10) hours, (29.21 ± 5.10) hours, and (54.20 ± 5.69) hours, which were significantly shorter than those in the control group [(16.65 ± 2.16) hours, (33.25 ± 5.47) hours, (59.85 ± 5.87) hours, t = 4.783, 3.286 and 4.204, all P < 0.05]. The total incidence of postoperative complications in the observation group was significantly lower than that in the control group [13.51% (5/37) vs. 35.14% (13/37), χ2 = 4.698, P < 0.05]. Conclusion:Extrathecal Glisson maneuver for the resection of primary liver cancer exhibits better performance in the control of bleeding, reduction of postoperative complications, and acceleration of rehabilitation than extracorporeal Pringle maneuver.