手助腹腔镜在肝癌切除术中的临床应用分析

目的探讨手助腹腔镜在肝癌切除术中临床应用的价值。方法将近期手术切除的47例原发性肝癌随机分为3组：手助腹腔镜肝癌切除术（Ⅰ组）16例，单纯腹腔镜肝癌切除术（Ⅱ组）14例，开放式肝癌切除术（Ⅲ组）17例，对其治疗及效果进行统计分析。采用SPSSll．0软件，应用单因素方差分析法（One-WayANOVA），组间比较采用LSD检验。结果Ⅰ组与Ⅱ组的手术时间分别为3．46h及4．06h（P〈0．001），其差异有显著性；Ⅰ组与Ⅲ组的术中出血量、住院时间、肝功能影响、近期并发症率分别为119．38ml及238．82ml（P〈0．001），8．31d及10．53d（P〈0．001），47．13U／L及125．53U／L（P〈0．001），0．00％及23．53％（P—0．014），其差异有显著性。结论手助腹腔镜肝癌切除术具有微创、安全、效果好等优势，有较高的临床应用价值。

Hand-assisted laparoscopic resection of hepatic carcinoma

Objective To determine the value of hand-assisted laparoscopic resection of hepatic carcinoma. Methods The clinical data of 47 patients with hepatic carcinoma receiving surgical treatment in our hospital were collected. The 47 patients were randomized into 3 groups. Sixteen patients in group A were given hand-assisted laparoscopic resection, 14 in group B underwent laparoscopic resection and 17 in group C received open resection. Then statistical analysis was performed using the software SPSS11. 0. Results The operative duration was significantly different between group A and group B (3. 46 h vs. 4. 06 h, P<0. 001). Meanwhile, there were remarkable differences in blood loss (119. 38 ml vs. 238. 82 ml, P<0. 001), duration of hospitalization (8. 31 d vs. 10. 53 d, P<0. 001), increase of postoperative ALT level (47.13 U/L vs. 125. 53 U/L, P<0. 001) and incidence of postoperative complications (0 vs. 23.53%, P<0. 05) between group A and group C. Conclusions Hand-assisted laparoscopic resection of hepatic carcinoma is feasible, safe and effective.