Clinical Research And Open Hepatectomy In The Treatment Of Liver Tumor In Laparoscopic Liver Resection

Objective:In this paper, by means of laparoscopic liver resection and liver resection to compare the curative effect of operation and after operation, then certainly laparoscopic liver resection for the treatment of liver tumor in the clinical application value of laparoscopic liver resection, in order to evaluate the safety and feasibility of, and with open hepatectomy were compared superiority embodied and shortcomings.Methods:According to the selection of patients in the study inclusion criteria and exclusion criteria, the clinical data collected in the Department of general surgery of Yibin First People’s Hospital from 2010 January to 2012 January,45 cases of patients. According to the operation mode is divided into laparoscopic (LH, Laparoscopic hepatectomy) and laparotomy group (OH group, Open hepatectomy). The general information, operation time, postoperative observation and comparison of two groups of patients with bleeding in the carrying amount of time of drainage tube, blood transfusion, hepatic portal occlusion or not, postoperative hospital stay, postoperative use of analgesics, postoperative time, carrying the gastric tube after operation; postoperative complications; postoperative survival status indicator. The regular outpatient follow-up, follow-up by telephone or home health care workers were a combination of follow-up, the establishment of a unified, complete the registration database, with the recovery of patients after operation, and the postoperative complications. Results:The laparoscopic group and open group in age, gender, liver function classification, according to the clinical and pathological characteristics of the tumor resection, the location of the lesion diameter, pathological classification, pathological lesions, there was no significant difference (P>0.05). The operative time of laparoscopic group was 189.35±13.94 (min), the amount of bleeding was 517.83±69.74 (ml), blood transfusion in 2 cases, hepatic blood flow in 4 cases; control group operation time was 164.23±20.90 (min), the amount of bleeding was 612.27±41.85 (ml),8 cases of blood transfusion, blocking hepatic portal blood flow in 10 cases. The laparoscopic group and open group operation time is P>0.05, the two groups in operation time has no obvious statistical difference; the laparoscopic group and open group in the intraoperative bleeding, blood transfusion, whether blocking hepatic portal is all P<0.05, the difference was statistically significant. There was no significant peritoneal laparoscopic group and laparotomy group in the postoperative complications of bleeding, bile leakage, pulmonary infection, incision infection, intra-abdominal infection, ascites, pleural effusion (P>0.05) difference. The laparoscopic group and open group of postoperative complications in the total number of cases is no statistically significant differences (X2=1.171, P=0.279). The laparoscopic group, median survival was 26.70±0.92 (months), laparotomy group survived for a median of 24.33±0.83 (months), the two groups have no significant difference (P=0.857), laparoscopic liver resection and liver resection on survival after surgery there was no significant difference. Conclusion: Laparoscopic and open liver resection has good effect, for the treatment of benign and malignant hepatic tumors is feasible, but laparoscopic liver resection with small incision in the abdominal wall, postoperative use of analgesics, faster postoperative recovery, short hospitalization time and other advantages. Therefore, after comprehensive preoperative evaluation, choosing the suitable cases under the premise, benign and malignant hepatic tumors underwent laparoscopic liver resection is minimally invasive, safe, feasible, and recovery of laparoscopic liver resection compared with open hepatectomy has its unique advantages in the postoperative.