Laparoskopische Leberchirurgie

Schön, Michael P.; Justinger, Christoph

doi:10.1007/s00104-017-0413-4

Cited by 5 publications

(1 citation statement)

References 33 publications

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“…Especially for lesions with more local blood vessels or those prone to occult bleeding after operation, the effect of laparoscopic hemostasis is more thorough ( 7 ). Additionally, with this surgery, the surgical incision is small, which reduces the pain of patients, ensures the tightness of the abdominal cavity, reduces the contact bbetweeneen the abdominal cavity the and external environment, and is thus conducive to reducing infection rate and promoting the recovery of patients’ condition ( 8 ). Reportedly, compared with laparotomy, laparoscopic radical hepatectomy for LC has the same radical effect in treating LC, with the advantages of clear vision, small trauma, accurate hemostasis, quick recovery and light pain ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of laparoscopic radical hepatectomy and laparotomy for hepatocellular carcinoma and factors of postoperative recurrence

et al. 2023

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ObjectiveFor exploring the clinical efficacy of laparoscopic radical hepatectomy and laparotomy for hepatocellular carcinoma and analysing related factors of postoperative recurrence.MethodsTotally 212 patients with hepatocellular carcinoma admitted to our hospital between April 2017 and December 2020 were enrolled, and all of them were followed up after the operation. According to the treatment modes, the patients were assigned to a laparotomy group (n=106) and a laparoscopic group (n=106). Perioperative indicators, haematological examination results, complications and recurrence were compared between the two groups. The recurrence time of hepatocellular carcinoma after the operation was confirmed by imaging examination with definite mass, and logistic multivariate analysis was used for analyzing the risk factors associated with postoperative recurrenceResultsPatients in both groups were comparable in terms of general baseline data. The laparoscopic group experienced longer operation time and shorter incision length, less intraoperative blood loss, early time to have the first off-bed activity and time to eat liquid and shorter hospital stay than the laparotomy group (all P<0.05). Seven days after the operation, the laparoscopic group showed notably lower levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), tumour necrosis factor-α (TNF-α), interleukin-8 (IL-8), and C-reactive protein (CRP) than the laparotomy group (all P<0.05), and also showed notably higher levels of immunoglobulin A (IgA), IgG and IgM than the laparotomy group (all P<0.05). Additionally, the laparotomy group showed a higher total incidence rate of complications than the laparoscopic group (19.81% vs. 9.43%, P<0.05). During the one-year follow-up, the laparotomy group was not greatly different from the laparoscopic group in recurrence rate (22.64% (24/106) vs. 16.98% (18/106), P>0.05). Multivariate analysis showed that average tumour diameter and microvascular invasion were risk factors for postoperative recurrence (P<0.05).ConclusionLaparoscopic radical hepatectomy for hepatocellular carcinoma can reduce the influence on liver function and immune function, with less damage to tissues, and can ameliorate postoperative inflammatory reaction, and promote postoperative recovery of patients as soon as possible. There are many factors influencing the postoperative recurrence of hepatocellular carcinoma, and average tumour diameter and microvascular invasion are the risk factors.

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Section: Introductionmentioning

confidence: 99%