Lang H, Sotiropoulos G C, Frühauf N R, Radtke A, Malagó M, Broelsch Ch E
Klinik für Allgemein- und Transplantationschirurgie, Universitätsklinikum Essen.
Chirurg. 2004 Apr;75(4):424-9. doi: 10.1007/s00104-003-0803-7. Epub 2004 Mar 12.
Mesohepatectomy was performed in seven patients with a primary or secondary central liver tumor. We describe the surgical procedure for mesohepatectomy (removal of segments IVa/IVb/V/VIII +/- I) in the treatment of central hepatic tumors. This technically demanding but safe approach requires careful vascular dissection to maintain blood supply and venous drainage of the two remaining liver parts. Mesohepatectomy results in one or two large resection planes bearing a considerable risk of parenchymal necrosis or biliary leakage. Its major advantage over extended hepatectomy is the preservation of functioning liver tissue. Thus, the risk of postoperative liver failure is reduced and, in case of intrahepatic recurrence, the chance for repeat hepatectomy improved. Mesohepatectomy should be considered in selected cases of central liver tumors in which extended resection would be associated with a high risk of liver insufficiency.
对7例原发性或继发性肝中央肿瘤患者实施了肝中叶切除术。我们描述了肝中叶切除术（切除第IVa/IVb/V/VIII段 +/- 第I段）治疗肝中央肿瘤的手术过程。这种技术要求高但安全的方法需要仔细进行血管解剖，以维持剩余两个肝部分的血液供应和静脉引流。肝中叶切除术会形成一个或两个大的切除平面，存在实质坏死或胆漏的相当大风险。与扩大肝切除术相比，其主要优势在于保留了有功能的肝组织。因此，术后肝衰竭的风险降低，并且在肝内复发的情况下，再次肝切除术的机会增加。对于某些扩大切除会伴有高肝功能不全风险的肝中央肿瘤病例，应考虑肝中叶切除术。
