Application of different ways of hepatic blood flow occlusion in patients with liver cancer undergoing laparoscopic left hemihepatectomy
Objective To explore the application effects of different ways of hepatic blood flow occlusion in patients with liver cancer undergoing laparoscopic left hemihepatectomy.Methods 75 patients with liver cancer who underwent laparoscopic left hemihepatectomy were selected and divided into group A,group B and group C according to different ways of hepatic blood flow occlusion,with 25 cases in each group.Group A implemented the Pringle method,group B implemented the left hemihepatic sheath dissection blood flow occlusion method,and group C implemented the left hemihepatic sheath dissection blood flow occlusion and left hemihepatic veins exclusion.Three groups were followed up for 3 months after surgery.The perioperative related indexes of three groups were compared,including liver function,immune function,and levels of serum intercellular adhesion molecule-1(ICAM-1),macrophage movement inhibitory factor(MIF),C-reactive protein(CRP),interleukin(IL)-6 and IL-8 before surgery and at 3 days after surgery.Quality of life and incidence of complications during the follow-up period before surgery and at 3 months after surgery of three groups were compared.Results The amount of intraoperative bleeding in group C was lower than that in group A and group B,and group B was lower than group A(P＜0.05).The time of anal exhaust,the time of out of bed activiry and hospital stay in group C were shorter than those in group A and group B,and group B was shorter than group A(P＜0.05).Compared with before surgery,the levels of serum total bilirubin(TBIL),aspartate aminotransferase(AST),alkaline phosphatase(ALP),ICAM-1,CRP,IL-6,and IL-8 of three groups were increased at 3 days after surgery,and group C was lower than group A and group B,and group B was lower than group A(P＜0.05);the levels of serum prealbumin(PA)and peripheral blood CD3+,CD4+,CD4+/CD8+,and NK cell were decreased,and group C was higher than group A and group B,and the group B was higher than group A(P＜0.05);the level of serum MIF was decreased,and group C was lower than group A and group B,and group B was lower than group A(P＜0.05).Compared with before surgery,the scores of symptoms/adverse effects,social function,somatic function,and psychological function at 3 months after surgery of three groups were increased,and gruop C was higher than group A and group B,and group B was higher than group A(P＜0.05).The overall incidence of complications during the follow-up period in group C was lower than that in grou A and group B(P＜0.05).Conclusion Compared with the Pringle method and the left hemihepatic sheath dissection blood flow occlusion method,the left hemihepatic sheath dissection blood flow occlusion method and left hemihepatic veins exclusion method can effectively control intraoperative bleeding in liver cancer patients undergoing laparoscopic left hemihepatectomy,regulate the serum levels of ICAM-1,MIF,CRP,1L6,and IL-8 of patients,alleviate inflammation reactions,improve hepatic and immune functions of patients,which can promote postoperative recovery,shorten hospital stay,and improve the quality of life,with good safety.
liver cancerlaparoscopic left hemihepatectomyhepatic blood flow occlusionintercellular adhesion molecule-1macrophage movement inhibitory factorC-reactive protein
万方数据
维普
