| AimDiscussion about the efficiency of Liver Hanging maneuver (LHM) in Anatomic Hepatectomy for Primary Liver Cancer (PLC). Materials and methods1.Study designExperimental group:twenty cases of LHM from the Department of Hepatobiliary Surgery, First Affiliated Hospital of Chongqing Medical University who underwent anatomic hepatectomy for primary liver cancer by liver hanging maneuver between September 2008 and September 2010.Control group:Twenty eight cases of non - LHM from the Department of Hepatobiliary Surgery, First Affiliated Hospital of Chongqing Medical University, who underwent anatomic hepatectomy of Primary Liver Cancer without Liver Hanging maneuver between September 2008 and September 20102. Clinical data:LHM groups:Out of 20 cases,13 cases were male and 7 cases were female,with a mean age of 52.14±12.10 years(from 29 to 69 years old),including 11 cases which had tumor located in the left lobe of liver, 6 cases which had tumor located in the right lobe of liver, 1 case which had tumor located in left trisegment,2 cases which had tumor located in the middle lobe of liver.There were 2 cases which presented with a complication of hypertension and 2 cases with diabetes mellitus.Non- LHM group :Out of 28 cases,19 cases were male and 9 cases were female,with a mean age of 52.33±10.78 years(from 31 to 71 years old),including 15 cases which had tumor located in the left lobe of liver,9 cases which had tumor located in the right lobe of liver, 1 case which had tumor located in the left tri-lobe of the liver,1 case which had tumor located in the mid lobe of the liver,2 cases which had tumor located in the right lateral lobe of the liver . There was 1 case which presented with a complication of hypertension and 1 case with chronic bronchitis and 3 cases with diabetes mellitus.General anesthesia with tracheal intubation was applied. Surgical procedure was anatomic hepatectomy, the only difference is to evaluate the efficiency and efficacy of LHM exists or not?3 Observation indexes:(1) Intra-operative information: Includes; operating time, resection time and the amount of intra-operative bleeding and blood transfusion.(2) Post-operative recovery: Recovery of Liver functions (changes at day three of LFT`s i.e TBIL, ALT, Prothrombin activity), hospitalization time and postoperative complications (massive ascites, bile leakage).4 Statistical methods:Continuous data was expressed as mean±standard deviation. Categorical data were expressed as rate. The statistical software of SPSS 17.0 was introduced with X2 test or Fisher's exact test for numerical data,student's test of normal distribution and Wilcoxon rank-sum test of skewness distribution for the measurement of data. A P value<0.05 was considered significant.RESULTS:1.There was no significant difference between the two groups in the demographics of patients(P>O.05),2. There was a significant difference between the two groups in an intra-operative bleeding volume and blood transfusion (P<0.05),3. No significant difference were found between the two groups in operating time (P>0.05),4. There was a significant difference between the two groups in resection of liver (P<0.05),5. No significant differences were found between the two groups in recovery of the liver functions at the day third,6. There was no significant difference found between the two groups in leakage of bile, 7. There was a significant difference between the two groups in massive ascites, and,8. There was a significant difference between the two groups in hospitalization period.CONCLUSION1. LHM can significantly decrease the amounts of time in liver resection, intra-operative bleeding, transfusion and hospitalization period in Anatomic Hepatectomy for Primary Liver Cancer.2. LHM can reduce the occurrence of massive ascites in Anatomic Hepatectomy for primary liver cancer (PLC).3 .Our results emphasized the superiority of LHM in Anatomical Liver Resections for Primary Liver Cancer. |
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