肝细胞癌伴门静脉癌栓的手术治疗

Surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus

门静脉癌栓(PVTT)是肝细胞癌(简称肝癌)重要的生物学特性,也是其严重并发症和转移方式,手术切除仍然是目前肝癌伴PVTT最有效的治疗方法。介绍了肝癌伴PVTT手术治疗的历史与现状、PVTT形成的解剖学基础、PVTT分型、手术适应证、术式选择以及手术疗效评价。认为在循证医学的基础上建立个体化多学科治疗模式,可能是肝癌伴PVTT治疗的发展方向。

Portal vein tumor thrombus（ PVTT） is one of the important biological characteristics of hepatocellular carcinoma（ HCC）,and also a serious complication and a metastatic mode. Surgical treatment is still the most effective therapy for HCC with PVTT. This article describes the history and present situation of surgical treatment of HCC with PVTT,the anatomical basis for PVTT formation,classification of PVTT,indications for surgery,selection of surgical approaches,and evaluation of the surgical outcome of PVTT. Individualized multidisciplinary treatment should be developed based on evidence- based medicine,which might be the right direction for the treatment of HCC with PVTT.