腹腔镜与开腹肝切除治疗肝尾状叶腔静脉旁部肿瘤的临床研究

孙天歌; 王小军; 曹利; 李建伟; 陈健; 李雪松; 廖科曦; 郑树国

doi:10.16016/j.1000-5404.202012027

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腹腔镜与开腹肝切除治疗肝尾状叶腔静脉旁部肿瘤的临床研究

临床医学 | 更新时间：2026-01-09

- 腹腔镜与开腹肝切除治疗肝尾状叶腔静脉旁部肿瘤的临床研究
- Laparoscopic versus open liver resection for tumours originating in the paracaval portion of caudate lobe
- 第三军医大学学报 2021年43卷第7期页码：640-647
- 作者机构：
  
  400038 重庆，陆军军医大学（第三军医大学）第一附属医院全军肝胆外科研究所
- 作者简介：
  
  [ 郑树国，E-mail: shuguozh@163.com ZHENG Shuguo E-mail: shuguozh@163.com
- 基金信息：
  
  国家自然科学基金面上项目(81670597);第三军医大学西南医院重大领域技术创新项目(SWH2016ZDCX2015)
- DOI：10.16016/j.1000-5404.202012027
  中图分类号： R181.32;R730.56;R735.7
- 收稿：2020-12-03，
  
  修回：2021-01-12，
  
  纸质出版：2021-04-15
- 稿件说明：
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孙天歌, 王小军, 曹利, 等. 腹腔镜与开腹肝切除治疗肝尾状叶腔静脉旁部肿瘤的临床研究[J]. 第三军医大学学报, 2021,43(7):640-647.

Tiange SUN, Xiaojun WANG, Li CAO, et al. Laparoscopic versus open liver resection for tumours originating in the paracaval portion of caudate lobe[J]. Journal of Third Military Medical University, 2021, 43(7): 640-647.
孙天歌, 王小军, 曹利, 等. 腹腔镜与开腹肝切除治疗肝尾状叶腔静脉旁部肿瘤的临床研究[J]. 第三军医大学学报, 2021,43(7):640-647. DOI： 10.16016/j.1000-5404.202012027.

Tiange SUN, Xiaojun WANG, Li CAO, et al. Laparoscopic versus open liver resection for tumours originating in the paracaval portion of caudate lobe[J]. Journal of Third Military Medical University, 2021, 43(7): 640-647. DOI： 10.16016/j.1000-5404.202012027.

摘要

目的

比较腹腔镜肝切除（laparoscopic liver resection

LLR）与开腹肝切除(open liver resection

OLR)治疗腔静脉旁部来源肿瘤的围术期结果和远期疗效

探讨LLR治疗腔静脉旁部来源肿瘤的安全性和可行性。

方法

纳入2013年5月至2020年5月我院接受LLR或OLR的腔静脉旁部来源肿瘤患者42例

LLR组、OLR组恶性肿瘤患者中位随访时间分别为27.5、26.0个月。回顾性分析两组患者的围术期和远期疗效。

结果

行LLR和行OLR患者各21例。两组均无围手术期死亡

LLR组中1例患者中转开腹。LLR组与OLR组的手术时间、失血量、术中输血率、恶性肿瘤切缘及并发症发生率等差异均无统计学意义。与OLR组比较

LLR组术后进食时间早（

=0.042）、住院时间短（

=0.008）

术后第1、3、7天血清总胆红素水平低（

=0.004、0.010、0.018）。LLR组与OLR组恶性肿瘤患者的1年、3年总生存率差异无统计学意义(100.0%

87.5%

=0.292;87.5%

68.8%

=0.326）

1年、3年无瘤生存率差异也无统计学意义（62.5%

50.0%

=0.488;50.0%

37.5%

=0.455）。

结论

LLR治疗腔静脉旁部来源肿瘤对于选择性患者安全、可行

同时具有术后进食早、住院时间短的优势。

Abstract

Objective

To compare the perioperative outcomes and long-term efficacy of laparoscopic liver resection (LLR) and open liver resection (OLR) for hepatocellular carcinoma originating in the paracaval portion

and explore the safety and feasibility of LLR in treatment of paracaval-originating tumors.

Methods

Forty-two paracaval-originating tumor patients admitted in our hospital from May 2013 to May 2020 were enrolled in this study. The median follow-up time of the patients was 27.5 months in the LLR group and 26.0 months in the OLR group. Perioperative outcomes and long-term effect were analyzed retrospectively.

Results

There were 21 patients undergoing LLR and the other 21 OLR

and no perioperative death occurred. One case of the LLR group was converted to OLR during operation. There were no significant differences in operation time

blood loss

intraoperativ

e transfusion rate

resection margin of malignant tumour or postoperative complications. The LLR group obtained earlier postoperative feeding (

=0.042)

shorter length of hospital stay (

=0.008)

and lower postoperative total bilirubin at 1

3 and 7 d after surgery (

=0.004

0.010

0.018) when compared with the OLR group. What's more

no obviously differences were seen in 1- and 3-year overall survival rates (100.0%

87.5%

=0.292; 87.5%

68.8%

=0.326) or in 1- and 3-year disease-free survival rates (62.5%

50.0%

=0.488; 50.0%

37.5%

=0.455) between the 2 groups.

Conclusion

LLR is safe and feasible for paracaval-originating tumours in selected patients

with the advantages of earlier postoperative feeding and shorter hospital stay.

关键词

Keywords

references

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