ABSTRACT
The clinical data of 97 patients who underwent laparoscopic hepatectomy from July 2007 to November 2014 in the First Affiliated Hospital of Wenzhou Medical University was collected.Of the 97 patients,46 cases were diagnosed with hepatolithiasis,20 with primary liver cancer,26 with benign liver tumor,1 with liver abscess,and 4 with metastatic liver cancer.The surgical approaches included laparoscopic left hepatectomy (n =16),left lateral lobectomy (n =35),right hepatectomy (n =2),right posterior lobectomy (n =1),hepatic wedge resection (n =42),and left lateral lobectomy with segment Ⅶ resection (n =1),and 4 cases underwent multi-visceral resection.88 patients underwent laparoscopic hepatectomy and 9 patients were transferred to open hepatectomy.Postoperative complications included bile leakage (n =9),abdominal cavity infection (n =7),ascites (n =1),wound infection (n =1),pleural effusion (n =3) and pulmonary infection (n =1).There was no perioperative death.Taken together,laparoscopic hepatectomy is feasible and efficient for treating liver diseases and it has the advantages of minimal invasion and rapid recovery.
ABSTRACT
<p><b>BACKGROUND</b>Surgical treatment has become the standard treatment for nontraumatic diseases of the spleen. This meta-analysis compared the relative merits of laparoscopic splenectomy (LS) with open splenectomy (OS) for nontraumatic splenic diseases.</p><p><b>METHODS</b>A literature search was performed to identify studies comparing perioperative outcomes in patients who underwent LS or OS for nontraumatic diseases. Pooled odds ratios (ORs) and weighted mean differences (WMD) with 95% confidence intervals (CIs) were calculated using a fixed- or random-effects model.</p><p><b>RESULTS</b>Thirty-five studies matched the selection criteria. Of the 7 269 patients included 3 981 underwent LS and 3 288 underwent OS for nontraumatic diseases. OS was associated with shorter operation time (WMD = 42.65, 95% CI: 25.58-59.73), whereas LS was associated with reduced operative blood loss (WMD = -133.95, 95% CI: -229.02 to -38.88), need for blood transfusion requirement (OR = 0.53, 95% CI: 0.39-0.72), overall postoperative morbidity rate (OR = 0.44, 95% CI: 0.38-0.51), postoperative mortality rate (OR = 0.38, 95% CI: 0.24-0.59), and length of hospital stay (WMD = -2.73, 95% CI: -3.34 to -2.12).</p><p><b>CONCLUSIONS</b>LS is superior to OS for nontraumatic diseases, with reduced operative blood loss, need for blood transfusion, postoperative morbidity and mortality rates, and length of hospital stay, although OS is associated with reduced operation time. LS may be a good alternative to OS for patients with nontraumatic splenic diseases.</p>
