腹腔镜技术在肝肿瘤治疗领域的应用进展

Application progress of laparoscopy in the treatment of liver tumors

腹腔镜用于肝肿瘤治疗的历史已有近30年。30年来,世界范围的肝外科工作者对这一工具投入了极大的精力和热情,不断拓展和优化腹腔镜在肝肿瘤治疗中的应用范围和操作流程,使腹腔镜肝切除的手术适应证从最初的肝脏边缘良性肿瘤逐步扩展到左外叶、左半肝、右半肝、右后叶、尾状叶等肝脏所有区域或肝段联合切除。伴随着肝外科图像技术的升级、能量器械的更新、解剖思路的精进,腹腔镜在肝肿瘤治疗中的安全性、有效性、优越性得到了充分的保障和体现,层出不穷的基础和临床研究也充分证实了腹腔镜肝肿瘤治疗在围手术期效果方面的优势。对于长期治疗效果,持续的病例观察和策略调整仍是腹腔镜肝外科继续努力的方向。

Laparoscopy has been used for the treatment of liver tumors for nearly 30 years.Since then,the world’s liver surgeon giving a great deal of energy and enthusiasm to this tool,expanding indications and optimizing laparoscopy operation procedures,making indications of laparoscopic liver resection from the edge of liver benign tumors gradually extended to the left lobe,right lobe,left or right anterolateral segmentectomy or posterosuperior segmentectomy,right posterior sectionectomy,central hepatectomy,and extended left/right hepatectomy or caudate lobe.Accompanied by image technology upgrade,energy equipment update and the delicate anatomic stratagem,the security,effectiveness,advantages of laparoscopy in treatment of liver tumor got fully verified recently.There are plenty of basic and clinical research also fully confirmed the perioperative advantage of laparoscopic in liver cancer treatment.For the long-term therapeutic effect,continued case observation and strategy adjustment are still required in future.