| Objective: To explore the feasibility of laparoscopic hepatectomy for primary liver cancer by analysing the perioperative data of laparoscopic hepatectomy and open hepatectomy in the treatment of primary liver cancer.Method:Retrospectively analysing 73 patients with primary hepatocellular carcinoma who underwent hepatectomy between January 2014 and December2014 at the Fourth Hospital of Hebei Medical University.Among them,34 patients underwent laparoscopic hepatectomy(called LH group),39 patients underwent open hepatectomy(called OH group).The 73 patients with primary hepatocellular carcinoma were eligible for laparoscopic hepatectomy,followed by patients with voluntary principles before surgery,and performed by the same group of physicians by using intraoperative selection of self-made hilar blockade to block into the liver blood flow.The general information of the two groups of patients included: age,sex,liver function child classification,tumor diameter,tumor margin,resection,preoperative liver function(ALB、ALT、AST),there were no statistically significant(P> 0.05).10 indicators including the operation time,intraoperative hepatic portal occlusion time,intraoperative bleeding,total hospitalization cost,postoperative complications,postoperative analgesic condition,postoperative anal exhaust time,intraperitoneal drainage time,postoperative hospitalization time,postoperative liver function(postoperative day 3 ALB,ALT,AST)are analyzing by using statistical methods,in order to compare the differences between LH group and OH group.Statistical analysis was performed using spss21.The independent sample T test was used to compare the measurement data between groups.The Chi-square test or Fisher exact test was used for the intergroup count data,P<0.05 was statistically significant.Results:All cases of surgical procedures were smooth.LH group has no case of open laparotomy,73 patients without a case of death,were recovered after a good discharge.For the operative time(LH group 140.59±34.77 min,OH group 127.56±36.40 min,P=0.124),intraoperative hepatic portal block time(LH group 23.05±8.23 min,OH group 19.82±5.23 min,P=0.054),intraoperative blood loss(LH group 35.88±22.65 ml,OH group36.80±10.42 ml,P=0.83),total hospitalization costs(LH group55190.47±10175.66 yuan,OH group 57047.64±9098.24 yuan,P=0.41),postoperative complications(LH group without complications,OH group had2 cases of postoperative pleural effusion and 2 cases of postoperative surgical incision fat liquefaction)these aspect,the two groups compared to no statistically significant(P>0.05).Laparoscopic group were treated with analgesic drugs after operation(LH group of 12 patients with pain medication,25 patients did not use pain medication,OH group of 22 patients with pain medication,14 cases did not use pain medication,P= 0.014);postoperative anal exhaust time(LH group 3.15±0.50 day,OH group 4.41±0.59 day,P=0.00);abdominal drainage time(LH group 6.53±1.08 day,OH group 8.51±1.23 day,P=0.00);postoperative hospital stay(LH group 7.29±0.97 day,OH group9.07±1.30 day,P=0.00);postoperative liver function(LH group ALB36.73±3.32g/L,OH group ALB34.93±3.43g/L,P=0.03.LH group ALT102.29±78.64U/L,OH group ALTALT167.41±84.97U/L,P=0.001.LH group AST44.88±19.09U/L,OH group AST66.78±36.62U/L,P=0.002)were better than the open group,and the difference between the two groups compared was statistically significant(P <0.05).Conclusion:Compared to OH,LH has a small abdominal incision,the body trauma,mild pain,rapid postoperative recovery,significantly shorter hospital stay,etc,and it also can significantly improve the perioperative physical condition of patients with liver cancer.LH group compared with the OH group,the total cost of hospitalization has no significant difference.Therefore,after a goodpreoperative preparation,the appropriate case of choice,laparoscopic hepatectomy for primary liver cancer is minimally invasive,effective,safe and feasible,more effective than open hepatectomy.And LH is worth to carry out to promote in the appropriate hospital. |
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