Laparoscopic hepatectomy vs open surgery in the treatment of hepatic malignant tumors / 中华普通外科杂志

ABSTRACT

Objective To explore the feasibility and safety of laparoscopic hepatectomy in the treatment of hepatic malignant tumors.Methods 136 liver cancer patients were divided intolaparoscopic surgery group (LR group,51 cases) and open surgery group (OR group,85 cases).Serum enzyme,inflammatory factors and postoperative complications were compared between the 2 groups.Results The operative time of LR group was significantly longer than that of OR group (252 ± 123) min vs.(169 ± 63 min),hospitalization time (10 ± 5) d vs.(12 ± 5) d and intraoperative blood loss in LR group were lower than those in OR group (381 ±156) ml vs.(523 ±325) ml (all P＜0.05).ALT,AST,ALP in LR group was significantly lower than that in OR group [ALT(227 ±101) U/L vs.(690 ±575) U/L,AST(187±107) U/Lvs.(551 ±529) U/L,ALP(63 ±25)U/Lvs.(86 ±40)U/L,allP＜0.05].Prothrombin time in LR group was shorter than that in OR group [(14.3 ±0.8) s vs.(15.3 ± 1.6)s,P =0.000].The postoperative IL-6,TNF-α in LR group was lower than that in OR group [IL-6(154 ±31)pg/ml vs.(182 ±34) pg/ml,TNF-α(22 ±6) pg/ml vs.(30 ±7) pg/ml,all P ＜0.05].Postoperative complications in laparoscopic group were significantly lower than those in laparotomy group (3.9％ vs.11.8％,P ＜ 0.05).Conclusions Laparoscopic resection of liver malignant tumors is safer and has less complications,lower inflammatory stress response and liver injury.