Clinical Research Of Single-incision Laparoscopic Hepatectomy In Left Lateral Lobe For Hepatocellular Carcinoma

Objective:This study aimed to explore and compare the clinical efficacy of single-incision laparoscopic surgery and multi-incision laparoscopic surgery and evaluate the safety and effectiveness of the single-incision laparoscopic technique in left hepatectomy for liver cancer.Methods:A total of 53 cases of laparoscopic left hepatectomy for liver cancer performed by the same surgical team at Yunnan First People’s Hospital from January 2015 to January 2020 were included in this study.According to the surgical approach,the cases were divided into a single-incision laparoscopic group(single-incision group)of 25 cases and a multi-incision laparoscopic group(multi-incision group)of 28 cases.The differences in intraoperative bleeding,operation time,hospital stay,postoperative bowel movement time,postoperative drainage tube retention time,pain visual analog scale,postoperative incision scar score,cosmetic satisfaction score,postoperative complications,postoperative recurrence rate,postoperative survival rate,CUSUM learning curve were compared between the two groups.Results:1.A total of 53 patients were included in this study,with 25 cases in the singleincision group and 28 cases in the multi-incision group.There was no significant difference in baseline data between the two groups(P>0.05).In the clinical indicators of the operation time,specimen removal time,surgical incision length,postoperative incision scar score,pain visual analog scale,and cosmetic satisfaction score,the single-incision group had significant advantages over the multi-incision group(P<0.05).However,there was no significant difference in intraoperative bleeding,postoperative hospital stay,postoperative bowel movement time,postoperative drainage tube retention time,and postoperative blood tests on the first and third days(ALT,AST,WBC,ALP,Hb,TBLB)(P>0.05).2.There was no significant difference in postoperative treatment efficacy between the single-incision group and the multi-incision group,including perioperative complications,one-year mortality,one-year recurrence rate,and three-year progression-free survival curve indicators(P>0.05).3.There was no significant difference in the CUSUM learning curve and its phases between the two groups,but the SILS group had fewer cases in the unstable period of the second phase than the multiincision group.Conclusion(s):1.Single-incision laparoscopic left lateral hepatectomy is a safe and feasible technique for the surgical treatment of hepatocellular carcinoma.2.Single-incision laparoscopic left lateral hepatectomy is effective in the surgical treatment of hepatocellular carcinoma,and there is no significant difference in surgical efficacy compared to the porous laparoscopic technique.3.When comparing single-incision and multi-incision techniques for the surgical treatment of hepatocellular carcinoma,the former has clinical advantages,including shorter operation time,reduced postoperative pain,higher cosmetic satisfaction,and faster transition to mastery of the technique during the learning process.4.The widespread application of single-incision laparoscopic techniques in more medical centers and further research is of great clinical significance.