A clinical comparison of open anatomical hepatectomy with different approaches for the treatment of hepatocellular carcinoma
Objective To compare the clinical efficacy of open anatomical hepatectomy using different approaches for the treatment of hepatocellular carcinoma(HCC).Methods This study was a prospective randomized controlled study.Sixty-four patients with HCC admitted to the hospital from January 2020 to January 2023 were included.According to the random number table method,the patients were divided into a control group(n=32 cases,the patients received conventional approach for open anatomical hepatectomy)and an observation group(n=32 cases,the patients received open anatomical hepatectomy along with the main hepatic vein approach).The peri-operative related indexes,liver function indexes,immune function indexes and inflammatory factors levels before and 7 days after operation were compared between the two groups,and the postoperative complications of the two groups were counted.Results The intra-operative blood loss in the control group was(324.44±76.73)mL,which was statistically significant different with that of(250.27±68.64)mL in the observation group(t=4.075,P＜0.05).At 7 days after operation,the levels of aspartate aminotransferase,alkaline phosphatase,alanine aminotransferase and total bilirubin in the control group[(73.33±8.23)U/L,(94.44±9.19)U/L,(84.61±8.53)U/L and(24.39±2.64)μmol/L respectively]were higher than those in the observation group[(64.52±7.46)U/L,(94.44±9.19)U/L,(73.36±9.58)U/L and(22.14±2.96)μmol/L respectively,P＜0.05].Three days after operation,the levels of IgA,IgG and IgM in the control group(1.71±0.23,8.31±1.53 and 1.21±0.28,respectively)were lower than those in the observation group(1.95±0.24,9.39±1.75 and 1.35±0.32,respectively,P＜0.05).Three days after operation,the levels of serum interleukin-6,tumor necrosis factor-a,and C-reactive protein in the control group[(149.89±30.79)ng/L,(229.15±27.24)ng/L and(28.74±3.26)mg/L respectively]were higher than those in the observation group[(128.85±20.81)ng/L,(208.11±23.26)ng/L and(22.21±3.44)mg/L respectively,P＜0.05].The total incidence of postoperative complications in the control group was 21.88％(7/32),while that in the observation group was 15.63％(5/32),without statistical significant difference(x2=0.410,P=0.522).Conclusion Compared with conventional approaches,the use of a main hepatic vein approach in patients with HCC can alleviate the liver damage and immune dysfunction caused by open anatomical hepatectomy,thus has a higher safety.
Main hepatic vein approachAnatomical hepatectomyHepatocellular carcinoma
万方数据
维普
