腹腔镜与开腹肝切除术治疗肝脏后上段肿瘤的病例对照研究

肖乐; 李建伟; 陈健; 范毓东; 曹利; 郑树国

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腹腔镜与开腹肝切除术治疗肝脏后上段肿瘤的病例对照研究

论著 | 更新时间：2026-01-09

- 腹腔镜与开腹肝切除术治疗肝脏后上段肿瘤的病例对照研究
- Laparoscopic liver resection vs open liver resection for lesions located at posterosuperior segment of the liver: a case-control study
- 陆军军医大学学报 2014年36卷第24期页码：2471-2475
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  中图分类号： R572;R730.56;R735.7
- 纸质出版：2014
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肖乐,李建伟,陈健,范毓东,曹利,郑树国.腹腔镜与开腹肝切除术治疗肝脏后上段肿瘤的病例对照研究[J].陆军军医大学学报(原第三军医大学学报),2014,36(24):2471-2475.

　Xiao Le,Li Jianwei,Chen Jian,Fan Yudong,Cao Li,Zheng Shuguo.Laparoscopic liver resection vs open liver resection for lesions located at posterosuperior segment of the liver: a case-control study[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(24):2471-2475.
肖乐,李建伟,陈健,范毓东,曹利,郑树国.腹腔镜与开腹肝切除术治疗肝脏后上段肿瘤的病例对照研究[J].陆军军医大学学报(原第三军医大学学报),2014,36(24):2471-2475. DOI：

　Xiao Le,Li Jianwei,Chen Jian,Fan Yudong,Cao Li,Zheng Shuguo.Laparoscopic liver resection vs open liver resection for lesions located at posterosuperior segment of the liver: a case-control study[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(24):2471-2475. DOI：

摘要

目的探讨腹腔镜肝切除术治疗后上段肿瘤的安全性、可行性。方法回顾分析第三军医大学西南医院2009年1月-2013年1月手术治疗肝脏后上段肿瘤161例，其中腹腔镜肝切除58例（LLR组），开腹肝切除103例（OLR组）。结果两组间年龄、性别、病灶大小、Child-Pugh分级、病种分类、病灶位置、手术方式均无统计学差异；LLR组中转开腹率（5/58）8.62%，LLR组手术时间[(210.98±80.59) min，OLR组(230.51±67.01) min，P=0.101]，无统计学差异；LLR组术中失血量[(271.55±226.92)mL，OLR组(451.94±365.21)mL，P0.01]，有显著统计学差异；输血率、R0切除率比较，P值分别为0.536、1.000，无统计学差异；术后住院时间LLR组[(9.98±4.40)d，OLR组(14.51±6.00)d，P0.01]，有显著统计学差异。LLR组与OLR组并发症总体发生率17.2%、46.6%，(P=0.000)，有显著统计学差异

良性疾病病例无复发，恶性肿瘤病例复发率为30.56%、34.21%，P=0.701，无统计学差异；LLR组与OLR组1年生存率分别为94.44%、88.16%，P=0.498，1年无瘤生存率分别为88.89%、80.26%，P=0.256。LLR组与OLR组3年生存率分别为83.33%、69.74%，P=0.498，3年无瘤生存率分别为69.44%、65.79%，P=0.701，均无统计学差异。结论腹腔镜肝切除治疗后上段肿瘤安全、有效，同时具有术中出血、术后并发症少，以及术后住院时间短的优势。

Abstract

Objective To investigate the safety and feasibility of laparoscopic liver resection for lesions located at the posterosuperior segment of the liver. Methods The clinical data of 161 patients with lesions located at the posterosuperior segment of the liver who received surgery at Southwest Hospital from January 2009 to January 2013 were retrospectively analyzed. There were 58 patients who received laparoscopic liver resection (LLR group)

and 103 patients who received open liver resection (OLR group). Results There were no significant differences in the age

gender

lesion diameter

Child-Pugh classification

sorts of diseases

locations

and operation method between the 2 groups. Of the 58 patients who received the laparoscopic liver resection

5 cases (8.62%) were converted to the open liver resection. There were no significant differences in the mean operative time

blood transfusion rate and R0 resection rate between the 2 groups. However

the mean intraoperative blood loss was less in the LLR group than in the OLR group (271.55±226.92 vs 451.94±365.21 mL

P0.01). The postoperative hospital stay was shorter in the LLR group than in the OLR group (9.98±4.40 vs 14.51±6.00 d

P0.01). There was a lower rate of postoperative complications in LLR group than in the OLR group (17.2% vs 46.6%

P0.01)

but there were no differences of severe complications between the 2 groups. There was no recurrence and death occurrence in the patients with benign liver disease. The tumor recurrence occurred in 11 patients (30.56%) in the LLR group and 26 patients (34.21%) in the OLR group

which had no significant difference (P=0.701). There were also no significant differences in the 1-year rates of overall survival (94.44% vs 88.16%

P=0.498) and disease-free survival (88.89% vs 80.26%

P=0.256)

and the 3-year rates of overall survival (83.33% vs 69.74%

P=0.125) or disease-free survival (69.44% vs 65.79%

P=0.701)

between the 2 groups. Conclusion The laparoscopic liver resection is safe and feasible

and has the advantages of minimal operative trauma

and quick recovery of patients

when it is applied to the treatment of lesions located at the posterosuperior segment of the liver.

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