切换至 "中华医学电子期刊资源库"

中华普外科手术学杂志(电子版) ›› 2018, Vol. 12 ›› Issue (05) : 361 -363. doi: 10.3877/cma.j.issn.1674-3946.2018.05.001

所属专题: 述评/论坛 总编推荐 文献

院士述评

腹腔镜肝癌根治术的难点与争议
陈孝平1,(), 张万广1   
  1. 1. 430030 武汉,华中科技大学同济医学院附属同济医院肝脏外科中心
  • 收稿日期:2018-06-01 出版日期:2018-10-26
  • 通信作者: 陈孝平

Controversies and difficulties of laparoscopic resection of liver cancers

Xiaoping Chen1,(), Wanguang Zhang1   

  1. 1. Hepatic Surgery Center, the affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei 430030, China
  • Received:2018-06-01 Published:2018-10-26
  • Corresponding author: Xiaoping Chen
  • About author:
    Corresponding author: Chen Xiaoping, Email:
  • Supported by:
    Key clinical project of affiliated hospital of Ministry of Health(NO. 439-512010); Key special 12th 5-year National Science and Technology Supporting Project(2012ZX10002016-004)
引用本文:

陈孝平, 张万广. 腹腔镜肝癌根治术的难点与争议[J/OL]. 中华普外科手术学杂志(电子版), 2018, 12(05): 361-363.

Xiaoping Chen, Wanguang Zhang. Controversies and difficulties of laparoscopic resection of liver cancers[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2018, 12(05): 361-363.

随腹腔镜肝切除经验的积累和设备的改进,腹腔镜肝切除的手术指征与开放手术已基本相同。但由于肝癌肝切除本身就面临手术指征和切除范围等主要问题的争议,加上腹腔镜肝切除固有的较难控制出血、显露困难等问题,使腹腔镜这项技术应用在肝癌根治性切除中存在更多值得磋商的事项。本文就腹腔镜肝切除的手术适应证、切除范围及困难部位的肝切除等问题做一述评,以期对上述问题引起重视,使腹腔镜肝切除在临床应用中更加合理。

With rapidly improvement of surgical instrumentation and accumulation of surgical experience, indications of laparoscopic hepatectomy are basically the same as those of open surgery. However, several problems remain controversial such as surgical indications and the extent of liver resection, therefore laparoscopic hepatectomy is more difficult than other surgery, which required better skills of bleeding control and surgical exposure. This article reviewed the indications of laparoscopic hepatectomy, the extent and the difficulties of the resection, which required more attention, in order to make laparoscopic hepatectomy more reasonable in clinical application.

[1]
Reich H, McGlynn F, DeCaprio J, et al. Laparoscopic excision of benign liver lesions[J]. Obstet Gynecol, 1991, 78(5 Pt 2): 956-958.
[2]
Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008[J]. Ann Surg, 2009, 250(5): 825-830.
[3]
Wakabayashi G, Cherqui D, Geller DA, et al. Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka[J]. Ann Surg, 2015, 261(4): 619-629.
[4]
陈孝平,张万广.肝癌切除技术创新与发展[J/CD].中华普外科手术学杂志(电子版),2017,11(5):361-363.
[5]
Di B, Li Y, Wei K, et al.Laparoscopic versus open surgery for colon cancer: a meta-analysis of 5-year follow-up outcomes[J]. Surg Oncol, 2013, 22(3):e39- e 43.
[6]
Zhang FW, Zhou ZY, Wang HL, et al.Laparoscopic versus open surgery for rectal cancer: a systematic review and meta-analysis of randomized controlled trials[J]. Asian Pac J Cancer Prev, 2014, 15(22):9985-9996.
[7]
Yoneda G, Katagiri S, Yamamoto M.Reverse Trendelenburg position is a safer technique for lowering central venous pressure without decreasing blood pressure than clamping of the inferior vena cava below the liver[J].J Hepatobiliary Pancreat Sci, 2015, 22(6):463-466.
[8]
Zhang W, Wang J, Li C, et al. Infrahepatic inferior vena cava clamping with Pringle maneuvers for laparoscopic extracapsular enucleation of giant liver hemangiomas[J]. Surg Endosc, 2017, 31(9): 3628-3636.
[9]
Eguchi S, Kanematsu T, Arii S, et al. Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey[J]. Surgery, 2008, 143(4):469-475.
[10]
Wei F, Lu C, Cai L, et al. Can laparoscopic liver resection provide a favorable option for patients with large or multiple intrahepatic cholangiocarcinomas? [J]. Surg Endosc, 2017, 31(9): 3646-3655.
[11]
Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection-2, 804 patients[J]. Ann Surg, 2009; 250(5):831-841.
[12]
Abdalla EK, Adam R, Bilchik AJ, et al. Improving resectability of hepatic colorectal metastases: expert consensus statement[J]. Ann Surg Oncol, 2006, 13(10):1271-1280.
[13]
Margonis GA, Buettner S, Andreatos N, et al. Anatomical Resections Improve Disease-Free Survival in Patients With KRAS-mutated Colorectal Liver Metastases[J]. Ann Surg, 2017, 266(4):641-649.
[14]
Zhong FP, Zhang YJ, Liu Y, et al. Prognostic impact of surgical margin in patients with hepatocellular carcinoma: A meta-analysis[J]. Medicine, 2017, 96(37):e8043- e8043.
[15]
Terasawa M, Ishizawa T, Mise Y, et al. Applications of fusion-fluorescence imaging using indocyanine green in laparoscopic hepatectomy[J]. Surg Endosc, 2017, 31(12):5111-5118.
[1] 钟锴, 蒋铁民, 张瑞青, 吐尔干艾力·阿吉, 邵英梅, 郭强. 加速康复外科在肝囊型棘球蚴病肝切除术中的应用分析[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 425-429.
[2] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[3] 常小伟, 蔡瑜, 赵志勇, 张伟. 高强度聚焦超声消融术联合肝动脉化疗栓塞术治疗原发性肝细胞癌的效果及安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 56-59.
[4] 冯旺, 马振中, 汤林花. CT扫描三维重建在肝内胆管细胞癌腹腔镜肝切除术中的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 104-107.
[5] 赖全友, 高远, 汪建林, 屈士斌, 魏丹, 彭伟. 三维重建技术结合腹腔镜精准肝切除术对肝癌患者术后CD4+、CD8+及免疫球蛋白水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 651-654.
[6] 唐梅, 周丽, 牛岑月, 周小童, 王倩. ICG荧光导航的腹腔镜肝切除术临床意义[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 655-658.
[7] 杭轶, 杨小勇, 李文美, 薛磊. 可控性低中心静脉压技术在肝切除术中应用的最适中心静脉压[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 813-817.
[8] 公宇, 廖媛, 尚梅. 肝细胞癌TACE术后复发影响因素及预测模型建立[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 818-824.
[9] 李一帆, 朱帝文, 任伟新, 鲍应军, 顾俊鹏, 张海潇, 曹耿飞, 阿斯哈尔·哈斯木, 纪卫政. 血GP73水平在原发性肝癌TACE疗效评价中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 825-830.
[10] 刘敏思, 李荣, 李媚. 基于GGT与Plt比值的模型在HBV相关肝细胞癌诊断中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 831-835.
[11] 焦振东, 惠鹏, 金上博. 三维可视化结合ICG显像技术在腹腔镜肝切除术治疗复发性肝癌中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 859-864.
[12] 陈晓鹏, 王佳妮, 练庆海, 杨九妹. 肝细胞癌VOPP1表达及其与预后的关系[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 876-882.
[13] 袁雨涵, 杨盛力. 体液和组织蛋白质组学分析在肝癌早期分子诊断中的研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 883-888.
[14] 吴警, 吐尔洪江·吐逊, 温浩. 肝切除术前肝功能评估新进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 889-893.
[15] 吴雪云, 胡小军, 范应方. 肝切除术中剩余肝再生能力的评估与预测[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 894-897.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?