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目的:比较腹腔镜下解剖性肝切除与非解剖性肝切除治疗肝细胞癌的效果。方法:抽取2015年2月至2020年4月于南阳市第二人民医院完成腹腔镜下解剖性肝切除治疗并3年随访的50例肝细胞癌患者纳入观察组，将同期于医院完成腹腔镜下非解剖性肝切除治疗并3年随访的50例肝细胞癌患者纳入对照组。比较两组手术相关指标，术前与术后7 d测定两组肝功能指标如总胆红素(TBIL)、白蛋白(ALB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)并比较；比较两组复发、存活情况和并发症发生情况。结果:两组住院时间比较，差异未见统计学意义(n P>0.05)；观察组术中出血量少于对照组，手术时间长于对照组，差异有统计学意义(n P0.05)；术后7 d，两组TBIL、AST、ALT较术前升高，但观察组低于对照组，两组ALB较术前降低，但观察组高于对照组，差异有统计学意义(n P<0.05)；随访3年，观察组复发率低于对照组，差异有统计学意义(n P0.05)；观察组并发症发生率低于对照组，差异有统计学意义(n P0.05); the intraoperative blood loss in the observation group was less than that in the control group, and the operation time was longer than the control group, the differences were statistically significant (n P0.05); 7 days after operation, TBIL, AST, and ALT in the two groups were higher than those before surgery, but those in the observation group was lower than those in the control group, and ALB in the both groups was lower than that before operation, but that in the observation group was higher than that in the control group, the difference was statistically significant (n P<0.05); after 3 years of follow-up, the relapse rate of the observation group was lower than that of the control group, the difference was statistically significant (n P0.05); the incidence of complications in the observation group was lower than that in the control group (n P<0.05).n Conclusions:Laparoscopic anatomical hepatectomy can prolong the operation time of hepatocellular carcinoma compared with non-anatomical hepatectomy, but it will not prolong the hospital stay, and laparoscopic anatomical hepatectomy is more conducive to reducing intraoperative bleeding, alleviating liver function damage, reducing postoperative recurrence, and has fewer complications and high safety.