CAJ | 학술논문

目的评价和比较经腹腔镜与开腹根治性手术治疗肝脏囊型包虫病的临床疗效.方法回顾性分析2006年5月至2013年1月收住并接受根治性手术治疗的肝脏囊型包虫病患者的临床资料,并对手术时间、术中出血量、中转开腹率、平均术后住院时间、术后并发症进行统计学分析.结果本研究共纳入153例患者,其中41例行经腹腔镜手术(腹腔镜组)、112例行传统开腹手术(开腹组).腹腔镜组平均手术时间较开腹手术短,但差异无统计学意义(t=1.97,P＞0.05).腹腔镜组5例患者行中转开腹手术,中转开腹率为12.2％(5/41).2组术中出血量比较差异无统计学意义(t=2.00,P＞0.05).腹腔镜组平均术后住院时间为3～8 d,而开腹组为4～14d,差异有统计学意义(t=1.99,P＜0.05).腹腔镜组并发症发生率为4.9％(2/41)、开腹组并发症发生率16.0％(18/112),差异有统计学意义(x2=3.92,P＜0.05).结论腹腔镜肝包虫根治性手术治疗较传统开腹肝脏囊型包虫病手术治疗具有术后住院时间短,并发症少,恢复快,复发率低的特点,在严格选择患者的条件下是安全和可行的.
목적 평개화비교경복강경여개복근치성수술치료간장낭형포충병적림상료효.방법 회고성분석2006년5월지2013년1월수주병접수근치성수술치료적간장낭형포충병환자적림상자료,병대수술시간、술중출혈량、중전개복솔、평균술후주원시간、술후병발증진행통계학분석.결과 본연구공납입153례환자,기중41례행경복강경수술(복강경조)、112례행전통개복수술(개복조).복강경조평균수술시간교개복수술단,단차이무통계학의의(t=1.97,P＞0.05).복강경조5례환자행중전개복수술,중전개복솔위12.2％(5/41).2조술중출혈량비교차이무통계학의의(t=2.00,P＞0.05).복강경조평균술후주원시간위3～8 d,이개복조위4～14d,차이유통계학의의(t=1.99,P＜0.05).복강경조병발증발생솔위4.9％(2/41)、개복조병발증발생솔16.0％(18/112),차이유통계학의의(x2=3.92,P＜0.05).결론 복강경간포충근치성수술치료교전통개복간장낭형포충병수술치료구유술후주원시간단,병발증소,회복쾌,복발솔저적특점,재엄격선택환자적조건하시안전화가행적.
Objective To evaluate laparoscopic radical resection of liver hydatid cyst as compared with conventional open surgery.Methods From May 2006 to January 2013 clinical data of 41 patients undergoing laparoscopic radical resection of hepatic hydatid cyst were compared with those 112 cases treated by open surgery.Operation time,blood loss,conversion rate,length of hospitalization and recurrence rate were compared and analyzed.Results There was not statistical significant difference in operative time and blood loss between the two groups (t =1.97,P ＞ 0.05) (t =2.00,P ＞ 0.05).Five laparoscopic patients were converted to open surgery,conversion rate was 12.2 ％ (5/41),three due to inadequate exposure,and two for intraoperative bleeding.Postoperative hospital stay was significantly shorter in laparoscopic group than that in conventional group.The overall morbidity was 4.9％ (2/41) in laparoscopic and 16.0％ (18/112) in conventional group with statistical significance(x2 =3.92,P ＜ 0.05).Recurrence rate and mortality was 0 in both groups.Conclusions Laparoscopic radical resection of hydatid cyst is safe and effective in carefully selected patients and provides short hospital stay,good cosmetic result,fast recovery and fewer complications.