肝癌肝切除术的合理选择

The reasonable choice of hepatectomy for liver cancer

目的：探讨肝癌肝切除术合理选择研究的新进展。方法在PubMed、万方数据库以“肝癌”、“肝切除术”等为关键词，检索2009年1月—2015年1月有关肝癌肝切除术治疗的相关文献，结合国内外研究的最新进展，对肝切除术的合理选择进行分析总结。结果肝切除术目前是肝癌治疗的最有效方法之一，术前需对肝脏的残余功能进行详细评估。但临床上对于肝切除术的合理选择仍存在争议，其中包括肝硬化肝癌、单发巨大肝癌、多发性肝癌及肝癌合并癌栓的手术选择等，这些争议的存在往往会对患者的疗效产生显著影响。结论完善而全面的术前评估、个体化地选择合理术式及以肝段为基础的肝切除对于提高患者生存率至关重要。

Objective To review the research progress of hepatectomy for liver cancer.Methods To retrieve the related literatures about the progress on reasonable choice of hepatectomy for liver cancer in PubMed and Wanfang databases by the key words of ＂liver cancer＂ and ＂hepatectomy＂ from Jan. 2009 to Jan. 2015, and then analyze and summarize the recent research progress at home and abroad. Results Hepatectomy is one of the most effective therapies for live cancer.Preoperative detailed assessment should be carried out on the liver function of the residual. But the clinical selection of proper liver resection remains controversial. The disputes of liver resection are mainly concentrated on the patients with solitary large tumors, multiple tumors and liver cancer with portal vein tumor thrombus as well as cirrhosis. These controversies on the choice of surgical procedure for liver cancer may have significant impact on the efficacy of patients.Conclusions Comprehensive preoperative evaluation,individualized treatment selection of rational operation and liver resection based on liver segment are essential for improving patients＇ survival rate.