CAJ | 학술논문

目的：探讨腹腔镜下肝脏良性肿瘤切除术的可行性，安全性和临床结局。方法回顾性分析2013年10月至2015年2月22例行肝脏良性肿瘤行腹腔镜下肝脏切除术（腹腔镜组）的临床资料，与既往2009年1月至2013年10月34例行开腹肝脏切除术（开腹组）的资料对比。使用SPSS 19．0统计软件分析，两组手术时间、术中出血量、肝门阻断时间、术后镇痛药物使用量、肠功能恢复时间、住院天数等以均数±标准差表示，组间差异采用配对t检验，Fisher确切值检验，术后并发症采用卡方检验，P＜0．05认为差异有统计学意义。结果与开腹组相比，腹腔镜组术后肠功能恢复时间更短，住院天数也显著缩短，差异有统计学意义（t＝10．25， P＝0．001和t＝9．19， P＝0．008）；术后并发症：开腹组6例（17．65％，其中2例为切口疝），腹腔镜组0例（0），F ＝20．381， P ＜0．001。结论腹腔镜下肝脏切除术可以成为肝良性肿瘤肝切除的金标准，比开腹肝脏切除术具有更高的可行性和安全性，可以减少术后并发症和住院天数，减少患者的经济负担。
목적：탐토복강경하간장량성종류절제술적가행성，안전성화림상결국。방법회고성분석2013년10월지2015년2월22례행간장량성종류행복강경하간장절제술（복강경조）적림상자료，여기왕2009년1월지2013년10월34례행개복간장절제술（개복조）적자료대비。사용SPSS 19．0통계연건분석，량조수술시간、술중출혈량、간문조단시간、술후진통약물사용량、장공능회복시간、주원천수등이균수±표준차표시，조간차이채용배대t검험，Fisher학절치검험，술후병발증채용잡방검험，P＜0．05인위차이유통계학의의。결과여개복조상비，복강경조술후장공능회복시간경단，주원천수야현저축단，차이유통계학의의（t＝10．25， P＝0．001화t＝9．19， P＝0．008）；술후병발증：개복조6례（17．65％，기중2례위절구산），복강경조0례（0），F ＝20．381， P ＜0．001。결론복강경하간장절제술가이성위간량성종류간절제적금표준，비개복간장절제술구유경고적가행성화안전성，가이감소술후병발증화주원천수，감소환자적경제부담。
Objective To investigate the feasibility , safety, and clinical outcome of laparoscopic liver resection ( LLR) for benign liver tumors . Methods In the present study , 22 cases underwent LLR ( laparoscopic group ) from October 2013 to February 2015, and 34 cases underwent open liver resection (open surgery group) from January 2009 to October 2013.Measurement data were expressed as mean ±SD, including operation time , volume of blood loss , time of hepatic portal blockade , amount of postoperative analgesia, recovery time of intestinal function and hospital stay , which were analyzed retrospectively by Student's t test and Fisher's exact test using SPSS 19.0 software. Results Compared with the open surgery group , patients in the laparoscopic group showed quicker recovery of intestinal function and decreased hospital stay (t=10.25, P=0.001 and t=9.19, P=0.008, respectively).Postoperative complications occurred in 6 cases of the open surgery group (17.65%, 2 cases with incisional hernias ), and in 0 cases of the laparoscopic group (F=20.381, P<0.001). Conclusions LLR might be the gold standard for liver resection for benign liver tumors.The safety and feasibility of LLR are higher in the laparoscopic group than in the open surgery group with a lower overall morbidity , a shortened hospital stay and reduced medical costs .