Clinical analysis of laparoscopic versus open hepatectomy for hepatocellular carcinoma in the central region of liver based on three-dimensional image reconstruction
Clinical analysis of laparoscopic versus open hepatectomy for hepatocellular carcinoma in the central region of liver based on three-dimensional image reconstruction
Objective To compare the therapeutic efficacy of laparoscopic versus open hepatectomy based on three-dimensional image reconstruction in the treatment of hepatocellular carcinoma(HCC)in the central region of liver.Methods Clinical data of 118 patients with HCC located in the central region of liver undergoing hepatectomy in the People's Hospital of Zhengzhou University from January 2020 to Decem-ber 2023 were retrospectively analyzed,including 85 males and 33 females,aged(57.5±8.9)years old.According to surgical approach,patients were divided into two groups:the open surgery group(n=66)and laparoscopic surgery group(n=52).All patients underwent three-dimensional image reconstruction preopera-tively to determine the tumor location and its relationship with the hepatic vessels.The operative duration,intraoperative blood loss,incidence of postoperative complications,postoperative hospital stay,and prognosis were compared between the groups.Results Compared to open surgery,patients in laparoscopic group were younger[(55±9)years old vs.(59±8)years old],and experienced a longer operative time[212.5(152.5,262.3)min vs.161.5(135.8,210.0)min]and a shorter postoperative hospital stay[11.0(9.0,13.0)d vs.13.0(11.0,15.3)d](all P<0.05).Postoperative pathology indicated that R0 resection was achieved in both groups.The incidence of postoperative complications were comparable between the two groups[34.6%(18/52)vs.39.4%(26/66),x2=0.28,P=0.594].The 1-year and 3-year recurrence-free survivals were 69.7%and 53.0%in laparoscopic group,similar to those in open group(71.2%and 53.8%,respetctively,P=0.953).Conclusion Laparoscopic hepatectomy based on three-dimensional image reconstruction is safe and feasible for HCC in central region in terms of clinical prognosis.Laparoscopic surgery is also associated with a shorter postoperative hospital stay.