关键词:  肝肿瘤, Glisson蒂横断式肝切除, 非规则性肝切除, 疗效

Abstract:

Objective To investigate the clinical efficacy of methylene blue staining notation and Glissonean pedicle transection for treating hepatocellular carcinoma. Methods A total of 25 patients underwent methylene blue staining notation and Glissonean pedicle transection （combined group），and 23 patients underwent irregular liver resection （irregular group）. The two groups were compared in terms of mean operating time，blood loss，AST levels at 1 and 4 days after surgery，1-year survival and recurrence rates. Results No mortality was observed in either group. Compared to the irregular group， the combined group showed significantly shorter mean operating time［（120.16±15.45） min vs （130.26±8.48） min，t=2.77，P<0.05］，lower blood loss ［（252.40±81.25） ml vs（493.44±100.96） ml，t=8.42，P<0.05］，and smaller increases in AST at postoperative day 1 [（143.76±49.48） U/L vs （253.82±77.79）U/L，t=5.90，P<0.05] and postoperative day 4 ［（79.36±24.51）U/L vs （129.57±45.66） U/L，t=4.80，P<0.05］. The rate of positive tumor excision was 4.0% in the combined group and 8.7% in the irregular group（P>0.05）. The rate of perioperative complications was lower in the combined group（12.00% vs 39.13%，P<0.05），as was the 1-year recurrence rate（20.00% vs 47.83%，P<0.05）. Survival rates at 1 year were similar in the two groups（80.00% vs 78.26%，P>0.05）. Conclusion Methylene blue staining notation combined with Glissonean pedicle transection offers several advantages over irregular resection for treating hepatocellular carcinoma，including less intraoperative bleeding，fewer postoperative complications，lower tumor recurrence and better postoperative recovery.

Key words: Liver neoplasm, Glissonean pedicle transection method, Irregular liver resection, Efficacy