切换至 "中华医学电子期刊资源库"

中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (03) : 247 -249. doi: 10.3877/cma.j.issn.1674-3946.2019.03.011

所属专题: 文献

论著

完全腹腔镜下与开腹手术治疗复发性肝癌的疗效及CCL18水平变化比较
陈建勋1,()   
  1. 1. 617067 四川省攀枝花市中心医院肝胆外科
  • 收稿日期:2018-05-23 出版日期:2019-06-26
  • 通信作者: 陈建勋

Comparison of Total Laparoscopic and Open Surgery for Recurrent Hepatocellular Carcinoma and Changes in CCL18 Levels

Jianxun Chen1,()   

  1. 1. Department of hepatobiliary surgery, Panzhihua Central Hospital, Sichuan Panzhihua, Sichuan 617067
  • Received:2018-05-23 Published:2019-06-26
  • Corresponding author: Jianxun Chen
  • About author:
    Corresponding author: Chen Jianxun, Email:
引用本文:

陈建勋. 完全腹腔镜下与开腹手术治疗复发性肝癌的疗效及CCL18水平变化比较[J/OL]. 中华普外科手术学杂志(电子版), 2019, 13(03): 247-249.

Jianxun Chen. Comparison of Total Laparoscopic and Open Surgery for Recurrent Hepatocellular Carcinoma and Changes in CCL18 Levels[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(03): 247-249.

目的

对比分析完全腹腔镜下与开腹手术治疗复发性肝癌的疗效及趋化因子配体18(CCL18)水平变化。

方法

回顾性分析2013年6月至2016年4月手术治疗复发性肝癌患者66例资料,根据手术方案不同将患者分为腹腔镜组(n=36)与开腹组(n=30)。采用SPSS 20.0软件进行分析处理,术中术后指标、疼痛评分、CCL18水平等计量资料采用均数±标准差表示,独立t检验;肿瘤复发率、转移率、生存率等采用卡方检验。P<0.05时差异有统计学意义。

结果

腹腔镜组患者的手术时间、术中出血量、术后下床活动时间以及术后肛门排气时间等各项指标水平均明显低于开腹组患者(P<0.05);术后1 d、3 d、5 d、7 d腹腔镜组患者的VAS疼痛评分均明显低于开腹组患者(P<0.05);术前两组患者血清CCL18水平无明显差异(P=0.868);术后,腹腔镜组患者的血清CCL18水平明显低于开腹组(P<0.05)。两组肿瘤复发率、转移率以及2年生存率差异均无统计学意义(P>0.05)。

结论

复发性肝癌患者采用完全腹腔镜切除术的临床效果优于开腹手术,可有效减少手术时间和术中出血,患者术后恢复更快,术后疼痛情况明显改善,具有一定的临床价值。

Objective

To compare the efficacy of total laparoscopic and open surgery for recurrent hepatocellular carcinoma and the changes in the level of Chemokine (C-C motif) ligand 18 (CCL18).

Methods

The data of 66 cases with recurrent hepatocellular carcinoma who underwent surgical treatment from June 2013 to April 2016 were retrospectively analyzed. Patients were divided into laparoscopic group (n=36) and laparotomy group (n=30) according to different surgical procedures. SPSS 20.0 software was used for analysis. The intraoperative and postoperative indexes, pain scores, CCL18 levels and other measurement data were expressed as mean±standard deviation, compared with independent t test. The tumor recurrence rate, metastasis rate, survival rate were compared with chi-square test. The difference was statistically significant at P<0.05.

Results

The operative time, intraoperative blood loss, time to get out of bed after operation and postoperative anal exhaustion time in the laparoscopy group were significantly lower than those in the laparotomy group (P<0.05). On the 1st, 3rd, 5th and 7th day after surgery, the VAS pain scores of the laparoscopy group were significantly lower than those of the laparotomy group (P<0.05). There was no significant difference in serum CCL18 levels between the two groups before surgery (P=0.868). Postoperatively, the serum levels of CCL18 in the laparoscopic group were significantly lower than those in the laparotomy group (P<0.05). There was no significant difference in recurrence rate, metastasis rate, and 2-year survival rate between the two groups (P>0.05).

Conclusion

The clinical effect of total laparoscopic resection in patients with recurrent liver cancer is better than open surgery. It can effectively reduce the operation time and intraoperative blood loss. The patients recover more quickly, and the postoperative pain was significantly relieved, which has certain clinical value.

表1 66例复发性肝癌患者不同术式两组患者的基线资料比较(±s)
表2 66例复发性肝癌患者不同术式两组患者术中术后各项指标比较(±s)
表3 66例复发性肝癌患者不同术式两组患者术后VAS疼痛评分比较(±s)
表4 66例复发性肝癌患者不同术式两组患者手术前后血清CCL18水平比较(±s)
表5 66例复发性肝癌患者不同术式两组预后情况比较[例(%)]
[1]
廖佳建,江斌,李猛. 腹腔镜肝切除在复发性肝癌治疗中的应用[J]. 现代肿瘤医学,2017,25 (10) :1578-1580.
[2]
郭泓瑞,梁英健,孟凡征,等. 腹腔镜小肝癌切除术难点与关键技术[J/CD]. 中华普外科手术学杂志(电子版), 2017 , 11 (5) :368-371.
[3]
Coelho FF, Bernardo WM, Kruger JAP, et al. Laparoscopy-assisted versus open and pure laparoscopic approach for liver resection and living donor hepatectomy: a systematic review and meta-analysis[J]. HPB (Oxford), 2018, 20(8): 687-694.
[4]
魏鑫,刘斌,王飞通. 三种不同肝切除术式治疗原发性肝癌的临床比较[J/CD]. 中华普外科手术学杂志(电子版), 2017,11 (5) :383-386.
[5]
洪文,张忠伟,丛鹏,等.腹腔镜下左半肝切除术治疗原发性肝癌的临床疗效及安全性[J]. 腹腔镜外科杂志,2017 , 22 (9) :653-656.
[6]
Xu J, Lu X, Zhang Y, et al. Laparoscopic associating liver tourniquet and portal ligation combined rescue transhepatic arterial embolization for staged hepatectomy: A case report[J]. Medicine (Baltimore), 2017, 96(43): e8378-e8378.
[7]
谢勇,马晓飞,刘晓平,等. 腹腔镜下复发肝癌切除术的临床效果观察[J]. 中国临床新医学,2017 , 10 (9) :860-863.
[8]
邓国明,张耀明,周臻涛,等. 完全腹腔镜解剖性右半肝切除治疗肝肿瘤[J]. 肿瘤基础与临床, 2017 , 30 (1) :63-64.
[9]
张中祥. 复发性肝癌患者再次手术治疗效果研究[J]. 实用肝脏病杂志,2017, 20(6):788-789.
[10]
Berardi G, Van Cleven S, Fretland A, et al. Evolution of Laparoscopic Liver Surgery from Innovation to Implementation to Mastery: Perioperative and Oncologic Outcomes of 2, 238 Patients from 4 European Specialized Centers[J]. J Am Coll Surg, 2017, 225(5): 639-649.
[11]
张浩,董科,俞小炯,等. 完全腹腔镜和开腹肝切除手术治疗原发性肝细胞肝癌的近期和远期疗效比较[J].实用医学杂志,2017 , 33 (12) :1943-1948.
[12]
赵永江,保红平,余凤,等. 完全腹腔镜下肝癌切除术的临床疗效分析(附88例报告)[J]. 腹腔镜外科杂志,2017 , 22 (9) :657-660.
[13]
崔虎啸,侯森.腹腔镜与开腹手术治疗原发性肝癌近期及远期疗效研究[J].临床心身疾病杂志,2017,23 (3): 22-24.
[14]
Zhou Q, Huang L, Gu Y, et al.The expression of CCL18 in diffuse large B cell lymphoma and its mechanism research[J]. Cancer Biomark, 2018, 21(4): 925-934.
[15]
Lin Z, Li W, Zhang H, et a1.CCL18/PITPNM3 enhances migration, invasion, and EMT through the NF-κB signaling pathway in hepatocellular carcinoma[J]. Tumour Biol, 2016, 37(3): 3461-3468.
[1] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[2] 刘世君, 马杰, 师鲁静. 胃癌完整系膜切除术+标准D2根治术治疗进展期胃癌的近中期随访研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 27-30.
[3] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[4] 常小伟, 蔡瑜, 赵志勇, 张伟. 高强度聚焦超声消融术联合肝动脉化疗栓塞术治疗原发性肝细胞癌的效果及安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 56-59.
[5] 谢田伟, 庞于樊, 吴丽. 超声引导下不同消融术对甲状腺良性结节体积缩减率、复发率的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 80-83.
[6] 屈翔宇, 张懿刚, 李浩令, 邱天, 谈燚. USP24及其共表达肿瘤代谢基因在肝细胞癌中的诊断和预后预测作用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 659-662.
[7] 李伟, 宋子健, 赖衍成, 周睿, 吴涵, 邓龙昕, 陈锐. 人工智能应用于前列腺癌患者预后预测的研究现状及展望[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 541-546.
[8] 皮尔地瓦斯·麦麦提玉素甫, 李慧灵, 艾克拜尔·艾力, 李赞林, 王志, 克力木·阿不都热依木. 生物补片修补巨大复发性腹壁切口疝临床疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 624-628.
[9] 公宇, 廖媛, 尚梅. 肝细胞癌TACE术后复发影响因素及预测模型建立[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 818-824.
[10] 李一帆, 朱帝文, 任伟新, 鲍应军, 顾俊鹏, 张海潇, 曹耿飞, 阿斯哈尔·哈斯木, 纪卫政. 血GP73水平在原发性肝癌TACE疗效评价中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 825-830.
[11] 刘敏思, 李荣, 李媚. 基于GGT与Plt比值的模型在HBV相关肝细胞癌诊断中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 831-835.
[12] 焦振东, 惠鹏, 金上博. 三维可视化结合ICG显像技术在腹腔镜肝切除术治疗复发性肝癌中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 859-864.
[13] 陈晓鹏, 王佳妮, 练庆海, 杨九妹. 肝细胞癌VOPP1表达及其与预后的关系[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 876-882.
[14] 袁雨涵, 杨盛力. 体液和组织蛋白质组学分析在肝癌早期分子诊断中的研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 883-888.
[15] 吴警, 吐尔洪江·吐逊, 温浩. 肝切除术前肝功能评估新进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 889-893.
阅读次数
全文


摘要