A comparative study of laparoscopic precise hepatectomy with conventional open hepatectomy in the treatment of primary hepatocellular cancer

Abstract

Purpose: To compare the short-term efficacy and safety of laparoscopic precise hepatectomy and conventional open hepatectomy in the treatment of primary hepatocellular cancer.

Methods: 90 patients with primary hepatocellular cancer admitted to our hospital from September 2015 to September 2017 were collected and divided into the laparoscopic precise hepatectomy group (experimental group, n=45) and conventional open hepatectomy group (control group, n=45). The differences in operation time, intraoperative blood loss, postoperative time with drainage tubes, perioperative blood transfusion, postoperative hospital stay, postoperative liver function indicators, postoperative complications and 1-year tumor recurrence rate and survival rate after operation between the two groups were compared.

Results: The general clinical features of the two groups of patients were comparable, and there was no perioperative death. The operation time in the experimental group was longer than that in the control group (106.5±26.4 min vs. 95.2±21.3 min, p=0.028). The intraoperative blood loss in the experimental group was less than that in the control group (204.3±34.9 mL vs. 285.2±39.9 mL, p<0.001). The postoperative time with drainage tubes (6.2±1.7 days vs. 7.1±2.1 days, p=0.028) and postoperative hospital stay (8.1±2.5 days vs. 12.2±3.3 days, p<0.001) in the experimental group were significantly shorter than those in the control group. The levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the experimental group were significantly lower than those in the control group (p<0.05), while the levels of albumin (ALB) and total bilirubin (TBIL) in the former were obviously higher than those in the latter (p<0.05). The incidence rate of postoperative complications in the experimental group (15.6%) was evidently lower than that in the control group (35.6%; p=0.030). There was no significant difference in the 1-year recurrence rate between the two groups (p=0.086), and the 1-year survival rate in the experimental group was notably higher than in the control group (p=0.019).

Conclusion: Laparoscopic precise hepatectomy for the treatment of primary hepatocellular cancer significantly reduces intraoperative blood loss, shortens hospital stay, causes less trauma to patients and liver function damage, improves the 1-year survival rate, and has a lower incidence rate of complications than the traditional laparotomy, so it is worthy of clinical promotion.