| Objective: With the rapid development of minimally invasive techniques,laparoscopic surgery is more and more used in the treatment of hepatocellular carcinoma,but its advantages compared to traditional open liver resection and reliable tumor outcome is not completely clear.The main purpose of the test is to compare intra-operative,postoperative indexes and short-term follow-up results between laparoscopic and open liver resection in the treatment of hepatocellular carcinoma and to observe the safety,recovery speed,and short-term effect of laparoscopic liver resection.Method: From September 2014 to December 2015,14 patients with hepatocellular carcinoma underwent laparoscopic liver resection,all of which were included in the laparoscopic group.In the same period,14 patients with hepatocellular carcinoma who underwent open hepatectomy were selected and were enrolled in the open group.Two groups of patients were well matched in the terms of demographic characteristics(age,gender),preoperative clinical features(liver function Child classification,potential liver disease,AFP,tumor diameter)and operation type.Statistical analysis was performed to compare and assess the intra-operative,postoperative indexes and short-term follow-up results between the two groups.Result:The average amount of bleeding in laparoscopic group was 200±225.00 ml,3of the patients received intra-operative blood transfusion and the blood transfusion rate was 21.43%.The average operation time was 2.70 ±1.27 h.The average amount of bleeding in laparotomy group was 125±175.00 ml,and 14 patients had no need of intra-operative blood transfusion.The average operation time was 2.57±0.76 h.There were no significant differences in blood loss(P=0.124),blood transfusion rate(P=0.222)and operation time(P=0.748)between the two groups.There were significant differences between the two groups of paitents in analgesic treatment need(P = 0.041)and the time of postoperative first eating(P = 0.018),beginning to active(P = 0.002),placing peritoneal cavity drainage tube time(P = 0.009),and the hospital stay(P = 0.001).In the laparoscopic group,the average time of postoperative first eating,beginning to active,placing peritoneal cavity drainage tube time and the hospital stay were 1.00±1.00 days,3.00±1.00 days,6.00±2.00 days,and 7.0±1.25 days.9 of the patients had the need of analgesic treatment.In the open group,the average time of postoperative first eating,beginning to active,placing peritoneal cavity drainage tube time and the hospital stay were 2.00±1.25 days,5.00±3.25 days,8.50±3.50 days,and 9.5±2.75 days.All the patients had the need of analgesic treatment.Patients in the laparoscopic group had no postoperative complications,including major and minor complications.Postoperative complications occurred in 4patients of the open group,which were minor complications,including 1 cases of peritoneal effusion,1 cases of incision infection,1 cases of pulmonary infection and 1cases of abdominal pain.According to the statistical analysis,the complications in the30 days after the surgery between the two groups did not achieve the obvious difference(P=0.098).During half a year after the surgery,1 patients in the laparoscopic group had intrahepatic metastasis,and 3 patients in the open group had intrahepatic metastasis,2 of which died.According to statistical analysis,the recur rate half a year after the surgery between the two groups was not significantly different(P=0.596).Conclusion:Compared with open hepatectomy,patients receiving laparoscopic liver resection recovered eating earlier,began to active earlier,had lighter pain,and had a shorter hospital stay.The abdominal cavity drainage tubes were also removed earlier.In the terms of intra-operative bleeding volume,rate of blood transfusion,operative time,postoperative liver function recovery after 6-8 days,positive rate of cancer cells in liver specimens,complications and mortality after 30 days,and short-term recur rate,the two groups had no significant difference. |
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