Benefits of a modified local precision liver resection using intraoperative laparoscopic ultrasound in the treatment and prognosis of patients with liver cancer.
Beneficios de la resección hepática de precisión local modificada, utilizando ecografía intraoperatoria laparoscópica en el tratamiento y pronóstico de pacientes con cáncer de hígado.
Resumen
La tasa de incidencia y mortalidad del cáncer de hígado ha aumentado drásticamente. Además de la resección hepática abierta como método de tratamiento más común, la ecografía laparoscópica intraoperatoria (LUS) se ha utilizado recientemente en la hepatectomía. El objetivo de la investigación actual es responder a esta pregunta. 76 pacientes con cáncer de hígado ingresados en el Hospital de la Universidad de Beihua entre febrero de 2018 y septiembre de 2021 fueron asignados aleatoriamente a dos grupos de 38 pacientes, un grupo sometido a cirugía laparoscópica convencional (grupo control) y el otro grupo sometido a resección hepática laparoscópica precisa, después de colocar un instrumento LUS intraoperatorio (grupo de estudio). La pérdida de sangre y el daño a las venas hepáticas durante la cirugía fueron menores en el grupo de estudio (p < 0,05). Siete días después de la cirugía, los índices de función hepática (albúmina, bilirrubina total y alanina y aspartato aminotransferasas) e índices relacionados con la función inmune, interleucina 6, factor de necrosis tumoral α, linfocitos T CD3+ y CD4+ y nivel de células NK en el grupo de estudio mejoraron en comparación con el grupo control. Las complicaciones post- operatorias fueron menores en el grupo de estudio, y el seguimiento a los 9 meses mostró que la tasa de recurrencia fue menor y la tasa de supervivencia fue mayor en este grupo. Este estudio demuestra que la hepatectomía laparoscópica precisa modificada con el uso de la ecografía laparoscópica intraoperatoria da como resultado mejores resultados intraoperatorios y postoperatorios para el pronóstico y la tasa de supervivencia de los pacientes con cáncer de hígado, y hace que valga la pena generalizar esta técnica quirúrgica en la práctica clínica.
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