CAJ | 학술논문

目的探讨解剖性肝中叶切除治疗中央型肝癌的可行性及近期疗效.方法回顾性分析2007年1月至2011年12月收治的85例原发性中央型肝癌(单发,无远处转移),按照手术方式分为解剖性肝中叶切除术组(A组)共36例,非解剖性肝中叶切除术组(B组)共49例,比较手术策略,术中情况,术后并发症及近期复发转移情况. 结果 2组术中出血量差异无统计学意义(P＞0.05);各组术中输血量差异无统计学意义(P＞0.05);A组术后住院时间及总住院费用明显优于B组(P＜0.05);A组手术时间较B组长,2组比较差异有统计学意义(P＜0.05);并发症发生人数和发生人次2组有明显统计学差异;A组复发转移7例,占该组的19.4％ (7/36);而非解剖组复发转移20例,占该组的40.8％ (20/49),2组比较差异有统计学意义(P＜0.05).结论解剖性肝中叶切除具有手术打击小,术中出血少,术后渗出及并发症少,复发转移率低等优点,可作为治疗中央型肝癌的首选手术方式.
목적 탐토해부성간중협절제치료중앙형간암적가행성급근기료효.방법 회고성분석2007년1월지2011년12월수치적85례원발성중앙형간암(단발,무원처전이),안조수술방식분위해부성간중협절제술조(A조)공36례,비해부성간중협절제술조(B조)공49례,비교수술책략,술중정황,술후병발증급근기복발전이정황. 결과 2조술중출혈량차이무통계학의의(P＞0.05);각조술중수혈량차이무통계학의의(P＞0.05);A조술후주원시간급총주원비용명현우우B조(P＜0.05);A조수술시간교B조장,2조비교차이유통계학의의(P＜0.05);병발증발생인수화발생인차2조유명현통계학차이;A조복발전이7례,점해조적19.4％ (7/36);이비해부조복발전이20례,점해조적40.8％ (20/49),2조비교차이유통계학의의(P＜0.05).결론 해부성간중협절제구유수술타격소,술중출혈소,술후삼출급병발증소,복발전이솔저등우점,가작위치료중앙형간암적수선수술방식.
Objective To compare the efficacies of anatomic and nonanatomic mesohepatectomy for central type hepatocellular carcinoma.Methods The clinical data of 85 patients with central type hepatocellular carcinoma undergoing hepatectomies were retrospectively analysed.36 patients underwent anatomic mesohepatectomy and the other 49 patients did nonanatomic mesohepatectomy.The operative time,intraoperative blood loss,incidence of postoperative complications,postoperative drainage volume,time to flatus and length of postoperative stay between the two groups were compared.Results There were no significant differences in the general condition,organ function,tumor size and location between the two groups before operation (P ＞ 0.05).The intraoperative blood loss,incidence of postoperative complications,drainage volume were significantly less but the operative time longer in anatomic mesohepatectomy group than nonanatomic hepatectomy group (P ＜ 0.05).No differences between the two groups were found in regard to the time for flatus and length of postoperative hospital stay (P ＞ 0.05).Tumor recurrence developed in 7 cases in group A and 20 cases in group B (P ＜ 0.05).Conclusions Anatomic mesohepatectomy has the advantages of less surgical trauma,less exudation and complications in patients with central type hepatocellular carcinoma.