解剖性肝切除在肝癌治疗中临床价值的再认识

Reconsideration of the clinical value of anatomical hepatectomy in surgical resection of liver cancer

肝癌手术切除方式有解剖性切除和非解剖性切除,这两种术式在临床上的具体运用还存在争议。介绍了解剖性和非解剖性肝切除的技术要点。分析了解剖性肝切除对患者无瘤生存率和总体生存率的影响,非解剖性肝切除在合并有基础肝病的肝癌患者中的应用。对肝癌切除术后复发的机制进行了探讨。最后对解剖性肝切除的安全性、非解剖性肝切除和腹腔镜肝切除的优势进行简要总结。对于合并有肝硬化的肝癌患者,需要综合评估其肝功能和肿瘤情况来选择合适的肝癌手术切除方式。

The surgical resection of liver cancer consists of anatomical and non- anatomical resection,and controversy still exists over the application of these two procedures in clinical practice. This article introduces the technical points of anatomical and non- anatomical hepatectomy and analyzes the effect of anatomical hepatectomy on disease- free survival rate and overall survival rate,as well as the application of non- anatomical hepatectomy in liver cancer patients with underlying liver disease. The mechanism of recurrence after hepatectomy for liver cancer is also discussed. At last,this article summarizes the safety of anatomical hepatectomy and the advantages of non- anatomical hepatectomy and laparoscopic hepatectomy. As for liver cancer patients with liver cirrhosis,selection of the method for surgical resection of liver cancer should be based on a comprehensive evaluation of liver function and tumor condition.