精准肝切除术在治疗原发性肝癌中的应用

摘要

原发性肝癌(PLC)包括肝细胞癌(HCC)和肝内胆管细胞癌(CC),近年来全球发病率逐年增加.目前,肝癌的治疗方法趋于多样化,但手术切除仍为肝癌首选的、最有效的治疗方法.随着生物医学及循证医学、人文医学的兴起,以最小创伤获取最佳康复已成为现代外科追求的目标,也推动着传统经验外科模式向现代精准外科模式的转变.此外,术前评估、术中操作、围手术期处理的日益成熟以及手术器械的创新,亦促使精准肝切除术应运而生,并逐渐得到诸多肝胆外科医师的重视.本文着重从术前评估及术中操作两方面对精准肝切除术在原发性肝癌治疗中的应用进展进行综述.%Primary liver cancer (PLC) includes hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (CC).In recent years, the incidence of PLC has increased significantly in the world.At present, the therapy for liver cancer tends to diversify, but surgical resection is still the first choice and the most effective treatment for HCC in general.As the biomedical, evidence-based medicine, and medical humanities are proposed, to achieve the best therapeutic effect and minimize the trauma has become the goal of modem surgery.Moreover, this could promote the transformation of surgical model from traditional experiential surgery to precision surgery.Besides, as the critical techniques of treating HCC in preoperative evaluation,operative procedures, perioperative management and the innovation of surgical instruments develop fast, precise liver resection has come into being.And now this concept is getting more and more attention from hepatobiliary surgeons.In this paper, the progress on the application of precise liver resection in the treatment of PLC is reviewed based on the preoperative evaluation and intraoperative procedures.