精准肝切除治疗原发性肝癌

Precise hepatectomy in the treatment of primary liver cancer

目的探讨精准肝切除治疗原发性肝癌的临床体会及其操作要点。方法收集2012年6月至2015年6月诊断为原发性肝癌行肝切除的56例患者的临床资料，患者均于术前精准评估肝脏储备功能，行肝脏薄层CT扫描，利用原始数据三维重建肝脏、肿瘤、血管及胆道，模拟手术切除，计算剩余肝脏体积，预计手术难度、术后肝功能恢复及并发症等情况。结果53例患者均按术前拟实施方案行肝切除，预计剩余肝体积与实际剩余肝体积比较差异未见统计学意义（P〉0．05）。结论精准肝切除治疗原发性肝癌疗效显著，积极推广精准肝脏外科理念和技术有重要的临床应用价值。

Objective To investigate the operation point and the clinical experience of precise hepatectomy in the treatment of primary liver cancer. Methods Form June 2012 to June 2015, the clinical data of 56 patients who were diagnosed with primary liver cancer and deal with the treatment of precise hepateetomy were selected, patients＇ liver reserve function were accurately assessed before operation, and they were＇all taken the thin-slice CT scan of liver, tumors, vascular and biliary tract were taken three dimensional reconstruction with original data, simulated the surgical resection, calculated the remaining liver volume, expected the difficulty of operation, postoperative liver function and complications, etc. Results Precise hepatectomy was performed in 53 patients according to plan, there was no significant difference between renmaining liver volume expected and actual residual liver volume （P 〉 0. 05 ）. Conclusions The effect of precision hepatectomy on primary liver cancer is significant, has important value on actively promote the concept and technology of precision liver surgery.