纯腹腔镜肝切除术治疗80岁以上高龄患者肝细胞癌的疗效和安全性:一项多中心倾向分析

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2023-11-27 DOI:10.1002/jhbp.1395

Yosuke Namba, Tsuyoshi Kobayashi, Masakazu Hashimoto, Takashi Onoe, Hiroaki Mashima, Koichi Oishi, Naruhiko Honmyo, Tomoyuki Abe, Shintaro Kuroda, Hideki Ohdan

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摘要

背景:很少有报道评价超高龄患者腹腔镜肝切除术的安全性。我们使用倾向评分匹配评估了年龄≥80岁的肝细胞癌患者腹腔镜肝切除术的短期预后。方法:回顾性分析2012年1月至2021年12月期间广岛临床肿瘤外科研究组所属8家医院287例肝癌肝切除术患者(年龄≥80岁)的资料。采用倾向评分匹配法比较腹腔镜和开放肝切除术的围手术期结果。结果:287例患者中，腹腔镜肝切除术组83例，开放肝切除术组204例。进行倾向评分匹配，每组52例。两组间手术时间(p = 0.68)和pringle手法时间(p = 0.11)无显著差异。两组在胆漏或器官衰竭的发生率上无显著差异。腹腔镜肝切除术组术中出血明显减少，心肺并发症发生率较低(p)。结论:≥80岁的老年患者可安全进行腹腔镜肝切除术。

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The efficacy and safety of pure laparoscopic liver resection for hepatocellular carcinoma in super-elderly patients over 80 years: A multicenter propensity analysis

Background

Very few reports have evaluated the safety of laparoscopic liver resection in super-elderly patients. We assessed the short-term outcomes of laparoscopic liver resection in patients with hepatocellular carcinoma aged ≥80 years, using propensity score matching.

Methods

We retrospectively analyzed the data of 287 patients (aged ≥80 years) who underwent liver resection for hepatocellular carcinoma at eight hospitals belonging to Hiroshima Surgical study group of Clinical Oncology, between January 2012 and December 2021. The perioperative outcomes were compared between laparoscopic and open liver resection, using propensity score matching.

Results

Of the 287 patients, 83 and 204 were included in the laparoscopic and open liver resection groups, respectively. Propensity score matching was performed, and 52 patients were included in each group. The operation (p = .68) and pringle maneuver (p = .11) time were not different between the groups. There were no significant differences in the incidences of bile leakage or organ failure. The laparoscopic liver resection group had significantly less intraoperative bleeding and a lower incidence of cardiopulmonary complications (both p < .01).