腹腔镜肝切除术治疗肝癌的关键技术与实践

Clinical practice and key techniques of laparoscopic hepatectomy for liver cancer

近年来腹腔镜肝切除术治疗肝癌的报道例数迅速增加。越来越多的研究证实腹腔镜肝切除术治疗肝癌具有创伤小、恢复快、并发症少等优点,其手术时间、手术切缘及远期疗效与开腹手术相当。本文结合我们实践体会,介绍腹腔镜肝切除术治疗肝癌的关键技术。选择适宜患者、合理布孔、精确定位肿瘤、制定恰当切线、选择性血流阻断、精细的肝实质离断、积极预防出血及严格的无瘤原则是腹腔镜肝切除术治疗肝癌成功的关键。

Laparoscopic hepatectomy for liver cancer has developed dramatically in recent years. Accumulated evidence showed that laparoscopic hepatectomy for liver cancer is associated with mini-invasive, quick recovery, and fewer postoperative complications in selected patients, and without significant differences compared with traditional open surgery in terms of operation time, negative resection margin rate, and long-term clinical outcome. Based on our experience, appropriate patient selection, reasonable trocar placement, sensitive identification and accurate localization of the cancer, correct resection plane, selective inflow control, precise parenchyma transection, actively preventing haemorrhage and strictly performing ＂no touch＂ technique ＆ RO radical resection are the key techniques of successful laparoscopic hepatectomy for liver cancer.