肝癌肝切除断肝技术的优化应用

Optimization and application of liver transection techniques in hepatectomy for hepatocellular carcinoma

解剖性肝切除是治疗肝细胞癌的合理术式,肝脏离断方式是关系到肝脏手术成败的关键技术。肝脏的切除线和切割平面应选择在肝段、肝叶之间的乏血管区;入肝血流控制是常用的减少出血的方法;超声刀、Endo-GIA、超声吸引装置(CUSA)等能量外科器械的使用有助于减少术中出血,缩短手术时间,但其各有优缺点。术者应采用最熟练的断肝方法,选择合适的能量外科器械辅助手术,是保证肝脏离断顺利、手术成功的关键。

Anatomic liver resection is a reasonable procedure for the treatment of hepatocellular carcinoma. Liver transection is the key technique that decides the success or failure of liver resection. Pancivascular area between hepatic lobes or segments should be considered as the resection line and cutting plane. Vascular inflow control is commonly used to reduce intraoperative hepatic bleeding. The application of energy devices, may reduce intraoperative blood loss and shorten operation time,but each device has its advantages and disadvantages. To ensure the smooth of liver transection and the success of surgery,it is crucial for surgeons to apply their most skilled transection approach with appropriate energy devices.