Evaluation Of The Application And Effect Of Anatomic Resection And Non-anatomic Resection In The Surgical Treatment Of Hepatocellular Carcinoma

Objective To investigate the clinical value of anatomic resection(AR)and non-anatomic resection(NR)in the surgical treatment of Hepatocellular carcinoma,and to provide a clinical basis for the choice of appropriate surgical methods for surgeons.Methods The clinical data of 58 cases of patients with primary liver cancer who received diagnosis and treatment at our hospital during January 2015 to January 2018 were retrospectively analyzed.Anatomic resection was applied to 38 patients(AR group),whereas non-anatomic resection was applied to the rest 20 patients(NR group),of which 18 cases underwent laparoscopic liver resection,12 cases treated by regular hepatectomy,6 cases treated by irregular hepatectomy.Compare two groups of perioperative conditions,including the operation time and hospitalization time,intraoperative blood loss,blood transfusion amount and dissected tumor diameter.Levels of serum albumin(Alb),Alanine aminotransferase(ALT),Aspartate transaminase(AST),total bilirubin(TBIL),direct bilirubin(DBIL)in the two groups were determined.The incidence of postoperative complications,tumor recurrence rate,disease-free survival rate and overall survival rate in 1 year in the two groups were compared.Results No perioperative mortality was observed in the two groups.The operation time of AR group was longer than that of the NR group,but the operation bleeding,blood transfusion volume,hospitalization time,liver function 3 days after surgery,complication rate were significant better than those of the NR group,the difference was statistically significant(P<0.05).The 1-year recurrence rate of AR group lower than NR group(P<0.05),1-year disease-free survival rate higher than NR group(P<0.05),while there was no significant difference in 1-year overall survival rate between the two groups(P>0.05).The operation time of the laparoscopic group was longer than that of the open group(P>0.05),but the length of hospital stay,intraoperative blood loss and transfusion volume decreased,and the difference was statistically significant.The complication rate of the laparoscopic group was slightly lower,especiallyit is effective in preventing incisional infection,but there was no significant difference in the overall comparison(P>0.05).There was no statistically significant difference between the two groups in 1 year of tumor recurrence rate,no tumor survival rate and overall survival rate(P>0.05).Conclusion Anatomic hepatectomy is a safe and effective surgical method to meet the concept of precise hepatectomy,the postoperative liver function recovery is better,and the complications rate and early recurrence rate of tumor are lower,which has a good clinical therapeutic effect,but a good basal preoperative liver function is stictly reqired.As for liver cancer patients with severe liver cirrhosis、poorliver function orsmall liver cancer,selection of the method for surgical resection should be based on a comprehensive evaluation of hepaticreservationalfunction of the patient and biological characteristics of the tumor.Laparoscopic hepatectomy ensures a smaller wound,faster recovery and better cosmetic effect,and the clinical efficacy is also worth recognizing,which is an effective way to further promote in the clinical practice.