Effect Analysis Of Laparoscopic Anatomic And Non-anatomic Hepatectomy For Hepatocellular Carcinoma

Objective:Laparoscopic hepatectomy can be divided into two types:Laparoscopic anatomic hepatectomy(LAH)and Laparoscopic non-anatomic hepatectomy(LNAH).This article aims to explore the clinical efficacy of different laparoscopic hepatectomy for hepatocellular carcinoma(HCC)and analyze the influencing factors of prognosis.Method:1.The clinical data of 107 patients who were hospitalized in the Hospital from January 2014 to January 2018 and underwent laparoscopic hepatectomy and whose postoperative pathology was HCC were analyzed retrospectively,including 66 in LAH group and 41 in LNAH group.2.Collected the data of 107 patients and compared the intraoperative conditions, postoperative complications,postoperative hospital stay,disease-free survival(DFS)and overall survival(OS),and analyzed the influencing factors of prognosis.3.Analyzed the data through the SPSS21.0 software.The examination result as the difference has statistics significance take P<0.05.Result:1.A total of 107 patients with HCC,66 in LAH group and 41 in LNAH group were collected.Between the two groups,nothing difference in gender,age,PT value,Child Grade,cirrhosis,HBs-Ag,albumin,total bilirubin and tumor diameter.(P>0.05).2.Compared with LNAH group,difference take nothing with LAH group in intraoperative bleeding volume(135.00ml vs.117.68ml),hospitalization time(18d vs.16d),but there is difference in operation time(173.0min vs.145.3min)(P<0.05);3.Two group of patient Postoperative 1,3 year DFS has statistics difference(LAH vs.LNAH,1-year84.8%vs.80.5%,3-year 63.2%vs.39.2%,X~2=4.343,P=0.037),1,3 year OS has statistics difference(LAH vs.LNAH,1-year 95.5%vs.92.7%,3-year78.6%vs.64.3%,X~2=4.192,P=0.041).4.Single factor analysis showed that the differences in DFS take place in vascular tumor thrombus,operation mode,capsule invasion and tumor size(P<0.05),and the differences in OS is happen in capsule invasion,operation mode and tumor size(P<0.05);Cox multiple factors analysis suggested that operation mode and tumor size are independent risk factors in patients.Conclusion:1.Laparoscopic anatomical hepatectomy is more complicated than non-anatomical hepatectomy,delicate operation enables the operation time relatively long,but it will not increase the postoperative complications,so the operation mode is relatively safe.2.The prognosis of LAH for hepatocellular carcinoma is better than LNAH.3.Operation mode and tumor size are closely related to the prognosis of HCC.But the prognosis has nothing related with sex,HBs-Ag,liver cirrhosis,vascular tumor thrombus,age and capsule invasion.During surgical treatment,the liver reserve function of the patient and the anatomical location and size of the tumor should be fully considered to determine the surgical method.