完全腹腔镜术治疗开腹术后复发性肝细胞肝癌的疗效、安全性及预后分析

目的探讨完全腹腔镜术治疗开腹术后复发性肝细胞肝癌的疗效分析。 方法回顾性分析2014年3月至2016年4月接受治疗的47例开腹术后复发性肝癌患者的临床资料，根据手术方法不同分为完全腹腔镜组(n＝21)和开腹组(n＝26)。应用统计学软件SPSS21.0完成分析。并发症发生率及远期预后指标采用χ²检验；围术期指标采用( ±s)表示，独立样本t检验；P<0.05为差异有统计学意义。 结果腹腔镜组患者的手术时间、术中出血量、排气时间、下床活动时间和住院时间均低于开腹组患者(均P<0.05)；腹腔镜组并发症发生率为9.5%，开腹组为23.1%，差异无统计学意义(P>0.05)；腹腔镜组术后需镇痛治疗人数低于开腹组患者(P<0.05)；两组术后1周Child分级、30 d内死亡率及1年复发率差异无统计学意义(P>0.05)。 结论完全腹腔镜治疗开腹术后复发性肝细胞肝癌具有手术时间短、出血少、恢复快、住院时间短等优点，值得临床推广应用。

Efficacy safety and prognosis of complete laparoscopic surgery for recurrent hepatocellular carcinoma after open surgery

ObjectiveTo investigate the short-term and long-term prognosis of complete laparoscopic surgery for recurrent hepatocellular carcinoma after open surgery. MethodsThe clinical data of 47 patients with recurrent hepatocellular carcinoma after open surgery from March 2014 to April 2016 were retrospectively analyzed. The patients were divided into complete laparoscopic group (n=21) and open group according to the different surgical methods (n=26). Data analysis was performed by statistical software SPSS 21.0. The incidence of complication and long-term prognosis indictors in this study were qualitative data. The analysis was performed by χ² test. The short-term efficacy index was quantitative data, the data were expressed as mean±standard deviation, and the two samples were compared by independent t test. ResultsThe operation time, intraoperative blood loss, exhaust time, time of getting out of bed, and hospital stay in the laparoscopic group were lower than those in the open group (all P<0.05). The complication rate was 9.5% in the laparoscopic group and 23.1% in the open group, there was no significant difference between the two groups (P>0.05). The rate of analgesia treatment in the laparoscopic group was lower than that in the open group (P<0.05). There was no significant difference in the child grading one week after surgery, 30-day mortality and one-year recurrence rate between the two groups (P>0.05). ConclusionComplete laparoscopic surgery for recurrent hepatocellular carcinoma after laparotomy has the advantages of short operation time, less bleeding, quick recovery, short hospitalization time, which is worthy of clinical application.