Surgical Endoscopy ( IF 2.4 ) Pub Date : 2022-09-22 , DOI: 10.1007/s00464-022-09631-x Zhengchen Jiang 1 , Gang Du 2 , Xuyang Wang 3 , Xiangyu Zhai 4 , Guangyong Zhang 1 , Bin Jin 2, 4 , Sanyuan Hu 1
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Background
This study was designed to investigate the feasibility and safety of laparoscopic hepatic caudate lobectomy (LHCL) for treating liver tumor by comparing with the open hepatic caudate lobectomy (OHCL).
Methods
In the LHCL group, we included 24 patients with liver tumor received LHCL in Qilu Hospital of the Shandong University from January 2014 to January 2019. Meanwhile, 24 matched liver tumor patients underwent OHCL in our hospital served as control. Then we compared the patient characteristics, intraoperative parameters, and postoperative outcomes between LHCL group and OHCL group.
Results
There were no significant differences in gender, age, degree of cirrhosis, tumor size, preoperative liver function, Child–Pugh grading, proportion of liver cirrhosis, and tumor size between LHCL group and OHCL group (P > 0.05). No death was reported in both groups. The length of incision in LHCL group was significantly lower than that in OHCL group (4.22 ± 1.14 cm vs. 22.46 ± 4.40 cm, P < 0.001). The intraoperative blood loss in LHCL group was significantly lower than that of OHCL group (116.82 ± 71.61 ml vs. 371.74 ± 579.35 ml, P = 0.047). The total operation time, Pringle maneuver occlusion time, and blocking rate in LHCL group showed no statistical difference compared with those of the OHCL group (P > 0.05). The VAS scores at postoperative 24 and 48 h showed no statistical differences between LHCL group and OHCL group (P > 0.05). Compared with the OHCL group, significant decrease was noticed in the proportion of patients with severe pain 48 h after surgery (0 vs. 4.25 ± 0.46, P < 0.001) and dezocine consumption (90.45 ± 45.77 mg vs. 131.6 ± 81.30 mg, P = 0.0448) in the LHCL group.
Conclusion
LHCL is effective and feasible for treating liver tumor, which is featured by reducing intraoperative blood loss and serious pain.
Graphical abstract
中文翻译：
腹腔镜与开放手术肝尾状叶切除术：一项回顾性研究
背景
本研究旨在通过与开腹肝尾状叶切除术（OHCL）的比较，探讨腹腔镜肝尾状叶切除术（LHCL）治疗肝肿瘤的可行性和安全性。
方法
LHCL组纳入2014年1月至2019年1月在山东大学齐鲁医院接受LHCL治疗的24例肝肿瘤患者，同时选取在我院接受OHCL治疗的24例相匹配的肝肿瘤患者作为对照。然后我们比较了 LHCL 组和 OHCL 组的患者特征、术中参数和术后结果。
结果
LHCL 组与 OHCL 组在性别、年龄、肝硬化程度、肿瘤大小、术前肝功能、Child–Pugh 分级、肝硬化比例、肿瘤大小等方面差异均无统计学意义（ P > 0.05 ） 。两组均未报告死亡。LHCL组切口长度明显小于OHCL组（4.22±1.14 cm vs. 22.46±4.40 cm，P < 0.001）。LHCL组术中失血量明显低于OHCL组（116.82±71.61 ml vs. 371.74±579.35 ml，P =0.047）。LHCL组总手术时间、Pringle手法阻断时间、阻断率与OHCL组比较差异无统计学意义（P > 0.05)。LHCL组与OHCL组术后24、48 h VAS评分差异无统计学意义（P > 0.05）。与 OHCL 组相比，术后 48 小时出现剧烈疼痛的患者比例（0 对 4.25 ± 0.46，P < 0.001）和地佐辛用量（90.45 ± 45.77 mg对 131.6 ± 81.30 mg，P = 0.0448) 在 LHCL 组中。
结论
LHCL治疗肝肿瘤有效且可行，其特点是减少术中失血量和严重疼痛。
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