腹腔镜肝切除术治疗肝癌破裂出血的初步经验

Preliminary experience of laparoscopic hepatectomy for hepatocellular carcinoma rupture and hemorrhage

摘要:

目的 评估腹腔镜肝切除术治疗肝癌破裂出血的临床价值。方法 回顾性分析该院2016年1月－2019年9月采用腹腔镜肝切除术治疗肝癌破裂出血的7例患者的临床资料。结果 7例患者均顺利完成腹腔镜手术，与对照组比较，术中出血量明显减少，术后住院时间明显缩短，差异均有统计学意义（P < 0.05）。7例患者均无切口及腹腔种植，两组患者无瘤生存率及总生存率比较，差异均无统计学意义（P > 0.05）。结论 对于循环稳定、肝功能分级为Child—Pugh A级、肿瘤可切除、能耐受手术的肝癌破裂出血患者，行腹腔镜肝切除术是安全和可行的。

Abstract:

Objective To evaluate the efficacy and clinical outcomes of laparoscopic hepatectomy for spontaneous rupture of hepatocellular carcinoma.Methods Retrospective analysis was made on the clinical data of 7 cases of hepatocellular carcinoma rupture hemorrhage treated by laparoscopic hepatectomy from January 2016 to September 2019.Results All the 7 patients successfully completed laparoscopic surgery, compared with the open group, the intraoperative blood loss was significantly reduced, and the postoperative hospital stay was significantly shortened (P < 0.05). None of the 7 patients had incision or abdominal implantation. There was no significant difference in tumor-free survival rate and overall survival rate between the two groups (P > 0.05).Conclusion Laparoscopic hepatectomy is safe and feasible for patients with hepatocellular carcinnoma rupture who have stable circulation, liver function grade of Child-Pugh A, resectable tumor and tolerance of surgery.