Comparison Of Short-term Efficacy Between Laparoscopic And Open Hepatectomy

Background: Primary hepatocarcinoma includes hepatocellular carcinoma and cholangiocarcinoma,among which hepatocellular carcinoma is the most common pathological type.Due to the lack of typical clinical symptoms in the early stage of hepatocellular carcinoma,once the symptoms appear,most of them are in the advanced stage.What’s worse,hepatocarcinoma are insensitive to radiotherapy and chemotherapy.Therefore,early diagnosis and early combined treatment based on surgical resection are crucial to prognosis of patients with hepatocellular carcinoma.Objective: To compare the clinical efficacy of laparoscopic partial hepatectomy and traditional open partial hepatectomy for hepatocellular carcinoma,and to provide basis for the selection of surgical methods for hepatocellular carcinoma in clinical practice.Methods:1.A total of 171 patients who were newly diagnosed with HCC and received surgical treatment in our hospital from 09.01,2018 to 09.01,2020.09.01 were collected.2.According to whether patients underwent laparoscopy,they were further divided into open surgery group and laparoscopic surgery group.36 patients underwent laparoscopic partial hepatectomy,accounting for 21.05%;135 patients underwent open partial hepatectomy,accounting for 79.05%;Seventeen patients who had planned to undergo laparoscopic surgery were converted to open surgery due to various factors during the operation and included in the open surgery group;3.Statistical methods were used to analyze the general information of the whole sample,including the intraoperative and postoperative conditions of the two groups of data,and to compare the efficacy of the two groups of surgical methods;4.In order to avoid a variety of confounding factors affecting the validity of the conclusion of this study,30 groups of samples were matched according to the matching criteria of age,gender,BMI,hepatitis B surface antigen positivity,cirrhosis,preoperative blood sampling indexes,tumor number,location,size and stage of liver cancer in a ratio of 1:1.5.Statistical analysis was conducted on the data related to the intraoperative and postoperative conditions of the paired samples again to verify the efficacy of the two groups of surgical methods.Results: 1.In the overall sample,there were no significant differences between the laparoscopic group and the open group in age,sex composition ratio,hepatitis B surface antigen positive composition ratio,and liver cirrhosis positive composition ratio(P>0.05).The BMI value of the laparoscopic group was higher than that of the open group,and the difference was significant(P<0.05).There were significant differences in preoperative albumin value,total bilirubin value,ALT,AST,prothrombin time,alpha fetoprotein value,tumor size,location and stage between the two groups(P<0.05).There were significant differences in intraoperative blood loss,operative time,albumin value on the first day after surgery,prothrombin time on the first day after surgery,length of hospital stay and hospitalization cost(P<0.05),while there was no significant difference in white blood cell count on the first day after surgery(P >0.05).2.In the paired samples,there were no significant differences in operation time,white blood cell count on the first day after surgery,albumin value on the first day after surgery,and prothrombin time on the first day after surgery(P>0.05).There were significant differences in intraoperative blood loss,length of stay and hospitalization cost(P<0.05).Conclusion: Laparoscopic partial hepatectomy has the advantages of less injury,quick recovery and low cost in clinical application,which is more in line with the concept of accelerated rehabilitation surgery,and is the preferred surgical treatment for hepatocellular carcinoma.