DeMatteo R P, Fong Y, Blumgart L H
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA.
Baillieres Best Pract Res Clin Gastroenterol. 1999 Dec;13(4):557-74. doi: 10.1053/bega.1999.0048.
Surgical resection is the mainstay of treatment for malignant liver tumours and offers the only chance of cure. Advances in radiological imaging, surgical technique and peri-operative management have enabled liver resection to be performed safely. Partial hepatectomy is indicated for the treatment of hepatocellular carcinoma and hepatic metastases from colorectal cancer. In addition, it may be utilized for selected patients with liver metastases from other primary tumours. Total hepatectomy with transplantation may be of benefit in some patients with unresectable neuroendocrine metastases or small hepatocellular carcinomas. The role of cryosurgery has not been precisely defined, and it needs to be compared with other palliative therapies such as ethanol injection and hepatic artery embolization.
手术切除是恶性肝肿瘤治疗的主要手段，也是唯一的治愈机会。放射影像学、手术技术和围手术期管理的进步使肝切除能够安全进行。肝部分切除术适用于治疗肝细胞癌和结直肠癌肝转移。此外，对于其他原发性肿瘤肝转移的特定患者也可采用。全肝切除加肝移植对一些无法切除的神经内分泌转移瘤或小肝细胞癌患者可能有益。冷冻手术的作用尚未明确界定，需要与其他姑息治疗方法如乙醇注射和肝动脉栓塞进行比较。
