Feasibility and safety of laparoscopic anatomical right hemihepatectomy in the treatment of patients with primary liver cancer
Objective To explore the feasibility and safety of laparoscopic anatomical right hemihepatectomy in the treatment of patients with primary liver cancer(PLC).Method According to different surgical methods,60 patients with PLC were divided into control group(n=30,laparoscopic non-anatomical right hemihepatectomy)and study group(n=30,laparoscopic anatomical right hemihepatectomy).The perioperative indexes,stress indexes[cortisol(Cor),norepineph-rine(NE),C-reactive protein(CRP),interleukin-6(IL-6)],liver function indexes[total bilirubin(TBIL),alanine amino-transferase(ALT),aspartate aminotransferase(AST),albumin(ALB)],quality of life[quality of life scale for liver cancer(QOL-LC)],complications,recurrence,metastasis and survival were compared between the two groups.Result The in-traoperative blood loss,intraoperative blood transfusion volume and postoperative drainage volume in the study group were significantly less than those in the control group,the postoperative extubation time,first anal exhaust time,first feed-ing time,first getting out of bed time and hospital stay were significantly shorter than those in the control group,and the operative time was significantly longer than that in the control group,and the differences were statistically significant(P<0.01).One day after surgery,the Cor,NE,CRP and IL-6 levels in the two groups were higher than those at one day before surgery,and the Cor,NE,CRP and IL-6 levels in the study group were lower than those in the control group,and the dif-ferences were statistically significant(P<0.05).Seven days after surgery,the TBIL,ALT and AST levels in the two groups were higher than those at one day before surgery,the ALB levels were lower than those at one day before surgery,the TBIL,ALT and AST levels in the study group were lower than those in the control group,the ALB level was higher than that in the control group,and the differences were statistically significant(P<0.05).Three months after surgery,the dimensional scores and total scores of QOL-LC in both groups were higher than those at one day before surgery,and the dimensional scores and total score of QOL-LC in the study group were higher than those in the control group,and the dif-ferences were statistically significant(P<0.05).The total incidence of complications in the study group was lower than that in the control group(P<0.05).After 1-year follow-up,the recurrence and metastasis rate of the study group was low-er than that of the control group,and the survival rate was higher than that of the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with laparoscopic non-anatomical right hemihepatectomy,lapa-roscopic anatomical right hemihepatectomy in the treatment of PLC patients can promote postoperative recovery,reduce stress response,improve quality of life and survival rate,reduce the incidence of complications and recurrence and metas-tasis rate,and have less damage to liver function.
primary liver cancerlaparoscopic anatomical right hemihepatectomyfeasibilitysafety
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