我国肝癌诊断与治疗是否已到达外科4.0

Whether China has stepped into'Surgery 4.0'in diagnosis and treatment of hepatocellular carcinoma

探讨我国外科医师诊断与治疗原发性肝细胞癌(以下简称肝癌)是否已到达外科4.0。外科4.0是Hooshair A于2018年提出,主要是描述基于不同时期科学发现和应用推动外科发展的4个阶段:外科1.0(18―20世纪,外科科学期);外科2.0(1950―1980年,超大型手术和器官移植期);外科3.0(1980年至21世纪初,微创外科普及期)和外科4.0(21世纪初至今,数字外科期)。在医疗卫生领域中,数字科学的应用带来翻天覆地的改变。外科4.0主要是由大数据、人工智能、自动化、现代机器人和5G通讯五大科学推动,目前在外科领域初探成功,但在肝癌的诊断与治疗领域中,尚有很大发展空间。

This article aims to explore whether clinicians and surgeons in China have made enough progress to step into'Surgery 4.0'in management of primary hepatocellular carcinoma(HCC).As for'Surgery 4.0',the term was first introduced in 2018 by Hooshair A to describe the four important stages of development in surgery,and each of these stages developed as a result of new scientific inventions and applications at the material time periods.These four stages of surgical developments are:Surgery 1.0(from 18th to 20th centuries,also called the era of scientific surgery);Surgery 2.0(1950 to 1980,the era of ultra-major and transplant surgery);Surgery 3.0(1980 to early 21st century,the era of minimally invasive surgery);and Surgery 4.0(from early 21st century,the era of digital surgery).Digital science brings drastic changes in medicine and health-care.Surgery 4.0 is driven by the use of big data,artificial intelligence,automation,modern robots and 5G communication,which achives a preliminary success in surgical field.However,the application of Surgery 4.0 in diagnosis and treatment of HCC is still at its embryonic stage.