Treska V
Chirurgická klinika FN, Plzen.
Rozhl Chir. 2003 Aug;82(8):397-402.
In comparison with other types of therapy, surgical treatment offers the best chance of long-term survival to the patient with a malignant liver disease. It is the only radical therapy of patients with primary or secondary tumors of the liver. Liver surgery has been the subject of great development over the last years. The technique of liver resection entertained principal changes reflecting various technical advancements. The author deals in greater detail with the present terminology of liver resections. The second part of the contribution deals with the proper technique of the operations on the liver with the application of per-operation ultrasonography, ultrasound dissector, radiofrequency ablation, harmonic scalpel, argon coagulation and the spray pump (Tissomat) for the application of fibrin glue. The correct surgical technique, together with the application of technical background, makes a series of large liver resections possible without necessity of blood transfusions. Liver surgery belongs to highly specialized interventions, which should be performed only in centers dealing with full-extent liver surgery.
与其他治疗方式相比,手术治疗为患有恶性肝脏疾病的患者提供了最佳的长期生存机会。它是原发性或继发性肝脏肿瘤患者的唯一根治性治疗方法。在过去几年中,肝脏手术有了很大的发展。肝切除术技术发生了主要变化,反映了各种技术进步。作者更详细地探讨了目前肝切除术的术语。文稿的第二部分论述了肝脏手术的正确技术,包括术中超声、超声刀、射频消融、谐波刀、氩气凝固和用于应用纤维蛋白胶的喷雾泵(Tissomat)的应用。正确的手术技术,加上技术背景的应用,使得一系列大型肝切除术在无需输血的情况下成为可能。肝脏手术属于高度专业化的干预措施,应仅在具备全面肝脏手术能力的中心进行。