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目的:探讨腹腔镜规则性肝切除治疗肝细胞癌(HCC)的疗效。方法:回顾性分析深圳市人民医院2010年1月至2013年12月收治的64例HCC患者的临床资料,按手术方式和1∶1配对的研究方法分成腹腔镜组及开腹手术组,比较两种手术方式的临床疗效。结果:实施腹腔镜肝切除和开腹肝切除各32例,腹腔镜组无中转开腹,术中出血量(325±86.63)ml与开腹手术组(530±119.21)ml相比明显减少(P<0.05)。两组术后病理检查均证实HCC,切缘阴性。腹腔镜组术后禁食时间及腹腔引流留留置时间均明显小于开腹手术组(P<0.05),但肝功能的恢复、并发症发生率和1年内肿瘤复发率与开腹手术组相比无统计学差异(P>0.05)。结论:腹腔镜规则性肝切除治疗HCC安全、有效而且微创,值得推广。
Objective: To investigate the effect of regular laparoscopic hepatectomy on hepatocellular carcinoma (HCC). Methods: The clinical data of 64 patients with HCC who were admitted to Shenzhen People’s Hospital from January 2010 to December 2013 were retrospectively analyzed. The surgical methods and 1:1 pairing methods were divided into laparoscopic group and laparotomy group. The clinical efficacy of the two surgical methods. Results: Thirty-two cases underwent laparoscopic liver resection and open hepatectomy respectively. There was no conversion to laparotomy in the laparoscopic group. The intraoperative blood loss (325±86.63) ml was significantly reduced compared with the open surgery group (530±119.21) ml. P<0.05). HCC was confirmed by postoperative pathological examination in both groups, with negative margin. The postoperative fasting time and retention time of laparoscopic drainage in the laparoscopic group were significantly lower than those in the laparotomy group (P<0.05), but the recovery of liver function, the incidence of complications, and the rate of recurrence within one year were compared with those in the open surgery group. No statistical difference (P>0.05). Conclusion: Laparoscopic regular hepatectomy for the treatment of HCC is safe, effective and minimally invasive and worthy of promotion.