腹腔镜下规则性肝切除与肝肿瘤剥除术治疗肝血管瘤的临床疗效比较

目的 比较腹腔镜下规则性肝切除与肝肿瘤剥除术治疗肝血管瘤的临床效果.方法 回顾性分析60例肝血管瘤患者的临床资料,其中31例在腹腔镜下行规则性肝切除术为A组,29例腹腔镜下行肝肿瘤剥除术为B组.比较两组手术时间、术中出血量、住院时间、术后并发症及复发率.结果 A组手术时间、术中出血量、住院时间分别为(153.96±37.13)min、(440.08±110.03)ml、(9.03±2.01)d,B组分别为(92.06±27.44)min、(327.21±130.51)ml、(7.17±3.14)d,B组手术时间、术中出血量明显少于A组(P<0.05).两组术后多数出现谷丙转氨酶(ALT)、谷草转氨酶(AST)一过性升高,同时A组出现1例胆漏,均未见切口感染、脂肪液化及死亡等情况发生,术后并发症比较无统计学意义(P>0.05).两组术后随访(13.97±3.09)个月,A、B组复发率分别为6.5%、3.4%,两组比较无统计学意义(P>0.05).结论 治疗肝血管瘤倾向于选择腹腔镜下肝肿瘤剥除术,具有创伤小、恢复快、预后好的优点,但具体选择何种术式仍需根据肿瘤实际情况而定.

Comparative Study of Clinical Efficacy of Laparoscopic Hepatectomy and Hemangioma Enucleation for Hepatic Hemangioma

Objective To compare the clinical efficacy of laparoscopic hepatectomy and hemangioma enucleation in the treatment of hepatic hemangioma. Methods The clinical data of 60 patients with hepatic hemangioma were analyzed retrospec-tively,31 cases underwent laparoscopic hepatectomy were group A,and 29 cases underwent hemangioma enucleation were group B. The operation time,intraoperative blood loss,hospital stay,postoperative complications and recurrence rate were compared be-tween the 2 groups. Results The operation time,intraoperative blood loss,hospital stay of group A were (153. 96 ± 37. 13) min, (440. 08 ± 110. 03) ml and (9. 03 ± 2. 01) d,and of group B were (92. 06 ± 27. 44) min,(327. 21 ± 130. 51) ml and (7. 17 ± 3. 14) d,and the operation time and blood loss of group B were significantly less than those of group A (P<0. 05). The alanine aminotransferase ( ALT) and aspartate aminotransferase ( AST) were transient increasing of majority of the 2 groups after opera-tion,and there was 1 cases of bile leakage of the group A,and no incision infection,fat liquefaction and death occurred,there were no significant difference in postoperative complications (P>0. 05). The 2 groups were followed up for (13. 97 ± 3. 09) months, the recurrence rate of group A and group B were 6. 5% and 3. 4%,there were no significant difference (P>0. 05). Conclusion Treatment of hepatic hemangioma tends to select laparoscopic liver tumor resection,which has the advantages of small trauma, quick recovery and good prognosis,however,the specific choice of surgical approach should be based on the actual situation of the tumor.