精准肝切除在结直肠癌肝转移同期切除中的临床应用

目的 探讨精准肝切除在结直肠癌肝转移同期切除的临床疗效。方法 回顾性分析2004年1月~2014年6月符合研究条件的61例患者的临床资料,分为精准肝切除组(A组,n=31),Pringle法的传统肝切除组(B组,n=30),对比分析两组临床相关指标。结果 两组患者术前资料具有方差齐性(P>0.05),具备可比性。A组手术时间(318.3±50.6min)比B组(176.1±55.9min)长(P<0.05),但A组的术中出血量少(354.9±69.8mlvs543.4±114.8ml)、术后肝功能恢复快(ALT:383.7±100.9U/Lvs555.0±91.3U/L,AST:329.6±77.9U/Lvs406.6±105.2U/L,Alb:31.7±2.1g/Lvs30.5±1.7g/L)、并发症少(8例vs16例)、住院时间短(16.6±2.9天vs20.4±2.7天,P<0.05)。A组使用术中超声较术前新发现肝转移灶7例。结论 在结直肠癌肝转移同期手术中,精准肝切除优于传统肝切除。

Precise Hepatectomy for Synchronous Resection of Colorectal Liver Metastases

Objective To explore the treatment effect of precise hepatectomy for synchronous resection in colorectal liver metastases. Methods The clinical data of 61 patients who had colorectal liver metastases were retrospectively analyzed from Jan-2004 to Jun-2014. These patients were divided into two groups according to surgical methods: 31 cases for precise hepatectomy (group A) and 30 cases for traditional Pringle hepatectomy (group B). The clinical data was studied comparatively by these two groups. Results The average operating time was 318.3±50.6minutes and 176.1±55.9minutes for group A and group B respectively. The time spent on Group A was significantly longer than group B (P<0.05). The average amount of intraoperative bleeding was 354.9±69.8ml of group A, compared to group B which was 543.4±114.8ml (P<0.05). The liver function of group A on the 7th day after operation were better than group B (peak of ALT 383.7±100.9U/L vs 555.0±91.3U/L, peak of AST 329.6±77.9U/L vs 406.6±105.2U/L and peak of Alb 31.7±2.1g/L vs 30.5±1.7g/L) (P<0.05). Incidence rate of complication after operation in group A were less than group B (25.8% vs 53.3%,P<0.05). The average days of postoperative hospitalization were 16.6±2.9 days of group A compared to 20.4±2.7 days of group B. Group A was significantly shorter than group B (P<0.05). Meanwhile, 7 cases of new liver metastases were discovered by intraoperative ultrasound in group A. Conclusion Precise hepatectomy is better than traditional Pringle hepatectomy in synchronous resection of colorectal liver metastases.