Prospective cohort study of laparoscopic and open hepatectomy for hepatocellular carcinoma
Prospective cohort study of laparoscopic and open hepatectomy for hepatocellular carcinoma
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DOI：
10.1002/bjs.10294
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发表时间：
2016-12-01
影响因子：
9.6
通讯作者：
Zheng, S.
中科院分区：
文献类型：
--
作者：
Xiang, L.;Li, J.;Zheng, S.
背景腹腔镜肝切除术治疗直径小于等于5cm的肝细胞癌的安全性和可行性是公认的。腹腔镜在治疗大肝癌（5-10cm）中的作用仍有争议。本前瞻性队列研究旨在评估腹腔镜肝切除术治疗大肝癌的短期和长期疗效，并将其与开放式肝切除术进行比较。方法2012年1月至2015年4月，对单发肝癌（直径5-10cm）行开放或腹腔镜肝切除术的患者进行前瞻性观察研究。分析围手术期及随访资料。结果腹腔镜肝切除术128例，开腹肝切除术207例。腹腔镜组和开放组围手术期分别有1例和2例死亡。在128例患者中，有12例（94%）将腹腔镜肝切除术转为开放手术。腹腔镜组接受解剖性肝切除术的患者多于开放组（453%对217%；P=0001）。腹腔镜组术后并发症发生率为203%，而开放组为357% （P=0003）。平均（s.d）住院时间分别为114（31）天和158（77）天(P
BackgroundThe safety and feasibility of laparoscopic hepatectomy for hepatocellular carcinoma (HCC) with a diameter of 5cm or less is well recognized. The role of laparoscopy in treating large HCC (5-10cm) remains controversial. This prospective cohort study was undertaken to assess the short- and long-term outcomes of laparoscopic hepatectomy for large HCC and to compare this approach with open hepatectomy.MethodsPatients with a solitary HCC (diameter 5-10cm) who underwent open or laparoscopic hepatectomy were enrolled in a prospective observational study from January 2012 to April 2015. Perioperative and follow-up data were analysed.ResultsSome 128 patients underwent laparoscopic hepatectomy and 207 had an open hepatectomy. One and two perioperative deaths were reported in the laparoscopic and open groups respectively. Laparoscopic hepatectomy was converted to an open procedure in 12 (94 per cent) of 128 patients. More patients in the laparoscopic group underwent an anatomical hepatectomy than in the open group (453 versus 217 per cent; P=0001). The postoperative complication rate was 203 per cent for the laparoscopic group versus 357 per cent for the open group (P=0003). Mean(s.d.) duration of hospital stay was 114(31) and 158(77) days respectively (P