Compared The Efficacy Of Laparoscopy With Laparotomy For Left Lateral Primary Hepatic Carcinoma

Objective: The aim of this study is to analyze the survival outcome of laparoscopic left lateral sectionectomy when compared to open approach in patients with primary hepatic carcinoma.Methods: From January 2012 to December 2016,selected patients had primary hepatic carcinoma with hepatectomy performed,The patients were divided into laparoscopic and laparotomy group.Compared twenty-six patients underwent pure laparoscopic left-lateral hepatectomy with thirty-two patients undergoing open left-lateral hepatectomy under the case-matched tumor characteristics and liver function.The clinical parameters such as operation time,intraoperative blood loss,hospital stay,postoperative gastrointestinal function recovery time,TBIL,ALB,ALT,AST,tumor diameter and postoperative complications were compared.Also compared 1 year and 3 year over survival and disease-free survival.SPSS15.0 statistical software was used for statistical test,t-test was used to compare the two groups of measurement data;X2 test was used to compare the data between groups;the number of complications was less than 5,and the precision Fisher test was used.Time-dependent data such as postoperative survival time were expressed as median,with a significant difference at P <0.05.Results: Comparing laparoscopic group to open resection group,the operation time was 79 ±11min vs 105± 30min(P<0.05).the blood loss was 117±35 vs 243±73 ml(P<0.05).Hospital stay was 7±2 vs 14±2days(P<0.05).Postoperative gastrointestinal function recovery time was2.8 ±0.6days vs 4.4±0.9 days respectively(P<0.05).Postoperative pain scores were 4.3±1.9 vs 7.3±1.2(P<0.05).Postoperative 3 days ALB was 35.1±4.8g/L vs 33.2±4.1g/L(P<0.05).Postoperative 3 days ALT was 143.8±72.5U/L vs 216.1±149.5U/L(P<0.05).Postoperative 3 days AST was 133.5±58.6U/L vs 242.3±177.6U/L,Postoperative 3 days TBIL 20.3±4.5umol/ L vs 27.1±9.1umol/ L(P<0.05).Comparing laparoscopic group to open resection group complication rate was 3 cases(11.5%)vs 12 cases(37.5%).The overall survival rates at 1 year after surgery were 96.2% vs 93.8%.The overall survival rates at 3 years after surgery were 84.6% vs 81.3%.The 1-year disease-free survival rates were 84% vs 76.4%,and the 3-year disease-free survival rates were 70.2% vs 67.9%(P> 0.05).Conclusion: Laparoscopic left external lobectomy for patients with primary hepatic carcinoma is a safe and effective surgical method.The short-term outcomes have advantages over the traditional laparotomy,which is becoming a more favorable treatment option even for the current treatment.