CAJ | 학술논문

目的：比较手助腹腔镜肝切除技术在困难肝切除中的临床价值。方法回顾分析2010年1月~2012年12月64例腹腔镜困难肝切除患者的临床资料，其中全腹腔镜手术41例，手助腹腔镜手术23例。对比分析手助式、完全腹腔镜肝切除术的差异。结果两组患者一般资料比较差异无统计学意义（P>0.05），具可比性。手助腹腔镜组与全腔镜组的平均手术时间（240 vs 191 min），出血量（430 vs 220 ml）的差异有统计学意义（P<0.05），两组在平均住院费用方面的差异也有统计学意义（5.87 vs 4.74万）。但并发症发生率及术后住院时间的差异均无统计学意义，两组患者中恶性肿瘤的1年和2年复发率的差异也没有统计学意义。结论手助腹腔镜肝切除适用于一些风险较大的肝脏切除，具有手术时间短、术中出血少，总费用低等优势，作为全腹腔镜肝切除技术的一种补充，值得进行深入的研究评估。
목적：비교수조복강경간절제기술재곤난간절제중적림상개치。방법회고분석2010년1월~2012년12월64례복강경곤난간절제환자적림상자료，기중전복강경수술41례，수조복강경수술23례。대비분석수조식、완전복강경간절제술적차이。결과량조환자일반자료비교차이무통계학의의（P>0.05），구가비성。수조복강경조여전강경조적평균수술시간（240 vs 191 min），출혈량（430 vs 220 ml）적차이유통계학의의（P<0.05），량조재평균주원비용방면적차이야유통계학의의（5.87 vs 4.74만）。단병발증발생솔급술후주원시간적차이균무통계학의의，량조환자중악성종류적1년화2년복발솔적차이야몰유통계학의의。결론수조복강경간절제괄용우일사풍험교대적간장절제，구유수술시간단、술중출혈소，총비용저등우세，작위전복강경간절제기술적일충보충，치득진행심입적연구평고。
Objective To compare the outcomes of hand-assisted laparoscopic liver surgery (HALS) and pure laparoscopic liver surgery (PLS). Methods The clinical data were analyzed for 64 patients undergoing major hepatectomy with HALH (23 cases) and PLS (41 cases) between January, 2010 and December, 2012. Results The general data of the two groups were comparable. Compared with PLS, HALS was associated with a significantly shorter operative time (240 vs 191 min), less intraoperative blood loss (430 vs 220 ml, P<0.05), and a lower cost (P<0.05). There was no significant difference between the two groups in postoperative hospital stay, complication rates or recurrence rate of hepatocellular carcinoma. Conclusions HALS is safe for major liver resection with such advantages over PLS as causing less trauma and a lower cost.