Clinical outcome of laparoscopic precise liver resection in the treatment of primary liver cancer

Abstract

Objective To compare the clinical outcome of laparoscopic precise liver resection and open conventional hepatectomy in the treatment of primary hepatic carcinoma. Methods From May 2014 to December 2016, clinical data of 72 patients with primary liver cancer were analyzed retrospectively, who were divided into precise hepatectomy group (n=36 cases) and conventional hepatectomy group (n=36 cases). Statistical analysis were performed by using SPSS 19.0 software. Measurement data, such as operation indicators, including operation time, the amount of blood loss, length of hospital stay, the postoperative parameters of liver function and immune status, were expressed as ±s, and were examined by using independent t test. Count data such as the gender, the Child-Pugh staging and tumor staging of patients were examined by chi square test. A P value <0.05 was considered as statistically significant difference. Results There was no significant difference of operation time between the precise hepatectomy group and the conventional hepatectomy group. Compared with conventional hepatectomy group, the length of hospital stay and the amount of blood loss in the precise hepatectomy group were significantly decreased(P<0.05). The postoperative AST and ALT level in the precise hepatectomy group were significantly lower than those in the conventional hepatectomy group. The postoperative ALB and TBIL level in the precise hepatectomy group were significantly higher than those in the conventional hepatectomy group (P<0.05). At postoperative day 7, subsets of CD3+ , CD4+ and CD4+ /CD8+ were significantly decreased in both groups after operation, however the decreasing degrees of them in precise hepatectomy group were significantly less than those in conventional hepatectomy group (P<0.05), and there were significant postoperative changes of CD8+ subsets in both groups. About 2 weeks after operation these T lymphocyte subsets in both groups returned to their preoperative levels. Conclusion Laparoscopic precise hepatectomy for primary liver cancer has several advantages including less intraoperative blood loss, shorter hospital stay, better liver function and immune function, which is worthy of clinical application. Key words: Liver Neoplasms; Laparoscopy; Hepatectomy