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Effect and influence factor analysis of intrahepatic Glisson's sheath vascular disconnection approach for anatomical
Dapeng Qiu1, Hao Zhuang, Feng Han
1Department of Hepato-Biliary-Pancreatic Surgery, Henan Cancer Hospital affiliated to Zhengzhou University, Zhengzhou City, China.
Purpose:
To investigate the effects and influence factor analysis of intrahepatic Glisson's sheath vascular disconnection approach for anatomical hepatectomy by three-dimensional (3D) laparoscope.
Methods:
82 patients with liver cancer were selected and divided into the control group with 45 cases and observation group with 37 cases according to different treatment methods. The control group was subjected to conventional laparotomy or resection under two-dimensional (2D) laparoscope while the observation group was subjected to anatomical hepatectomy by intrahepatic Glisson's sheath vascular disconnection approach under 3D laparoscope, and the therapeutic effects were compared.
Results:
The operation time and porta hepatis anatomy time were not significantly different (p>0.05). The amount of bleeding in the observation group was less than that of the control group, and the difference was statistically significant (p<0.05). The achievement ratio of the operation in both groups was compared and showed no statistical difference (p=1.00). With a median follow-up time of 26.5 months, the complication occurrence rate in the observation group was significantly lower than that of the control group (p<0.05). Comparison of the survival rate of both groups showed no differences. The multivariate logistic regression analysis suggested that the average maximum diameter of tumor and tumor close to porta hepatis were independent risk factors that influenced the operative results of the observation group.
Conclusion:
Intrahepatic Glisson's sheath vascular disconnection approach by 3D laparoscope for anatomical hepatectomy was superior in terms of safety and effectiveness, and the average maximum diameter of tumor and tumor close to porta hepatis were independent risk factors that influenced the operative results.