A Comparative Study Of Laparoscopic Anatomical Hepatectomy And Non-anatomic Hepatectomy In The Treatment Of Primary Hepatocellular Carcinoma

Objective To compare the short-term and long-term effect of laparoscopic anatomical hepatectomy and non-anatomical hepatectomy in the treatment of HCC,and to study the factors that play a role in the two-year survival rate and recurrence rate,so as to provide basis for clinical work.Method A retrospective analysis was made of 28 cases of laparoscopic anatomical hepatectomy and 31 cases of non-anatomical hepatectomy from January 20,2015 to September 30,2017.Results Except for alanine aminotransferase(ALT)level,there was no differences between the two groups in preoperative indicators(P>0.05).There was no significant differences between the two groups in intra-operative indexes including operation time and bleeding volume(P>0.05).The aspartate aminotransferase(AST)and ALT levels of the non-anatomic group were significantly higher than those of the anatomical group 3 days after surgery(P<0.05),and no significant difference in the post-operative complications between the two groups was found(P>0.05).There was no significant difference in two-year survival rates between the two groups(P>0.05),but the two-year recurrence rate in the non-anatomical group was higher than that in the anatomical group(P<0.05).The multifactor analysis indicated that pre-operative ALT level,liver cirrhosis and operative method are the independent risk factors for two-year recurrence rate,and the independent risk factor for the two-year survival rate is preoperative Alpha fetoprotein(AFP)level(P<0.05).Conclusion Laparoscopic anatomical hepatectomy has strengths of avoiding the ischemia-reperfusion injury of the remaining hepatic parenchyma and reducing the recurrence rate to a certain extent.As long as the remaining volume of the hepatic parenchyma is enough,anatomical hepatectomy should be selected as far as possible to treat HCC.