中国腹腔镜肝癌根治术式选择与规范化

The selection and standardization of laparoscopic radical liver resection for hepatocellular carcinoma in China

腹腔镜肝切除术自问世至今已有近30年历史,逐渐发展为肝癌根治术的标准术式之一,在部分患者中获得了不逊于开放手术的肿瘤学疗效,其优势日益受到认可。依据是否预先解和阻断预切除肝脏的人肝和(或)出肝血流,腹腔镜肝切除术可分为解剖性和非解剖性肝切除两种具体术式,二者具有各自的应用范围和优缺点。本文结合文献和个人经验,就腹腔镜肝癌根治术的术式选择及规范化等进行简要论述。

Since the laparoscopic liver resection(LLR)had been first published for nearly 30 years,it has gradually developed into one of the standard radical operation for hepatocellular carcinoma(HCC).In selected patients,LLR has achieved oncological curative effect that is not inferior to open liver resection,and its advantages are increasingly recognized.LLR could be divided into anatomic and non-anatomic liver resection,depending on whether the liver is pre-dissected or blocked from inflow and/or outflow.They have their own scope of application,advantages and disadvantages.How to choose laparoscopic anatomic liver resection or laparoscopic non-anatomic liver resection for HCC remain controversial.Combined with relevant literature and personal experience,this paper briefly discusses the selection and standardization of laparoscopic radical liver resection for HCC.