Miyazawa M, Oishi T, Isobe Y, Kubochi K, Ikeuchi S, Shima S, Kitajima M
Department of Surgery, National Tokyo Medical Center, Japan.
Surg Laparosc Endosc Percutan Tech. 2000 Dec;10(6):404-8.
The treatment of hepatocellular carcinoma associated with liver cirrhosis necessitates local therapy in some patients because of severe hepatic dysfunction. Percutaneous ethanol injection therapy, the local therapy for such cancer of the liver, and percutaneous microwave coagulation therapy are detailed. The significant disadvantages of these procedures is their inability to evaluate precisely whether the tumor will develop complete necrosis after treatment because the cancer tissue cannot be excised with use of these procedures. Conversely, laparoscopic hepatectomy, which is minimally invasive surgery, has a disadvantage, that is, its difficulty in complex maneuvers, including hemostasis, ligation, and suture. The authors developed laparoscopic-assisted hepatectomy, which is hepatectomy by small incision during laparotomy with the use of laparoscopic observation. This report describes laparoscopic-assisted hepatectomy, which may allow the solving of problems with percutaneous ethanol injection therapy, percutaneous microwave coagulation therapy, and laparoscopic hepatectomy.
由于严重肝功能不全,部分肝硬化合并肝细胞癌患者需要进行局部治疗。本文详细介绍了经皮乙醇注射疗法(一种针对此类肝癌的局部治疗方法)和经皮微波凝固疗法。这些治疗方法的显著缺点是无法精确评估治疗后肿瘤是否会完全坏死,因为使用这些方法无法切除癌组织。相反,作为微创手术的腹腔镜肝切除术也有一个缺点,即包括止血、结扎和缝合在内的复杂操作难度较大。作者开发了腹腔镜辅助肝切除术,即在开腹手术过程中通过小切口进行肝切除术,并利用腹腔镜观察。本报告描述了腹腔镜辅助肝切除术,它可能解决经皮乙醇注射疗法、经皮微波凝固疗法和腹腔镜肝切除术存在的问题。