荧光腹腔镜肝切除术与常规腹腔镜肝切除术治疗HCC患者效果比较

doi:10.3969/j.issn.1672-5069.2020.03.031

摘要/Abstract

摘要： 目的研究荧光腹腔镜肝切除术与常规腹腔镜肝切除治疗肝细胞癌(HCC)患者的临床效果。方法 2014年8月～2017年8月我院收治的148例HCC患者被随机分为观察组74例和对照组74例,分别行荧光腹腔镜肝切除术和常规腹腔镜肝切除术。随访3年。结果观察组切缘肿瘤细胞阳性率为2.7%,显著低于对照组的13.5%(x²=5.804,P=0.016);两组围术期胸腔积液、发热、切口感染、胆漏和腹腔出血等并发症发生率比较差异无统计学意义(P＞0.05);观察组6 m、1 a和2 a生存率分别为98.6%、94.6%和90.5%,与对照组的95.9%、93.2%和86.5%比,无显著性差异(P＞0.05),但3 a生存率为85.1%,显著高于对照组的70.3%(P＜0.05);观察组3 a肿瘤复发率为27.0%,显著低于对照组的47.3%(P＜0.05)。结论与常规腹腔镜肝切除术比,采用荧光腹腔镜肝切除术能实现肿瘤切缘的可视化,保证肿瘤切缘安全,有利于提高HCC患者生存率。

关键词: 肝细胞癌, 荧光腹腔镜肝切除术, 腹腔镜肝切除术, 治疗 , ,

Abstract: Objective The aim of this study was to compare the clinical efficacy of fluorescent laparoscopic hepatectomy (FLH) and conventional laparoscopic hepatectomy (CLH) in the treatment of patients with hepatocellular carcinoma (HCC). Methods 148 patients with HCC were admitted to our hospital between August 2014 and August 2017, and were randomly divided into two groups,with 74 cases in each group. The patients in the control group underwent CLH, and those in the observation group underwent FLH. All patients were followed-up for 3 years. Results The tumor cell positive rate of surgical margins in the observation group was 2.7%, significantly lower than 13.5% in the control group(x²=5.804,P=0.016); there was no significant difference in perioperative period complications incidences such as pleural effusion, incision infection, bile leak and peritoneal bleeding in the two groups (P＞0.05); there were no significant differences as respect to six-month, 1-yearand 2-year survival rates (98.6%, 94.6% and 90.5% vs. 95.9%, 93.2% and 86.5%,P＞0.05) between the groups, but the 3-year survival rate in the observation group was85.1%, much higher than 70.3% in the control (P＜0.05); the 3-year tumor recurrence rate in the observation was 27.0%, significantly lower than 47.3% in the control group (P<0.05). Conclusion The fluorescent laparoscopic hepatectomy could visualize the incision margin of hepatic tumors which might improve the survival rate of patients with HCC.

Key words: Hepatocellular carcinoma, Fluorescent laparoscopic hepatectomy, Laparoscopic hepatectomy, Therapy

王亮亮,杨波,张卫国. 荧光腹腔镜肝切除术与常规腹腔镜肝切除术治疗HCC患者效果比较[J]. 实用肝脏病杂志, 2020, 23(3): 427-430.

Wang Liangliang,Yang Bo,Zhang Weiguo. Comparison of fluorescent laparoscopic hepatectomy and conventional laparoscopic hepatectomy in the treatment of patients with HCC[J]. Journal of Practical Hepatology, 2020, 23(3): 427-430.

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