Kaido Toshimi
Department of Surgery, Otsu Municipal Hospital, 2-9-9 Motomiya, Otsu, Shiga 520-0804, Japan.
Hepatogastroenterology. 2007 Sep;54(78):1825-30.
Randomized controlled trials (RCTs) have recently been aggressively carried out in the field of liver surgery as well as other surgical fields. This article reviewed RCTs investigating hepatectomy performed during the last decade to provide the most recent evidence in hepatic surgery. More than half of the RCTs have been performed in Asia, especially in Japan and China. RCTs concerning liver ischemia such as procedures for vascular occlusion and preventive measures against ischemia/reperfusion injury have been most frequently carried out. RCTs on surgical procedures including devices to transect liver parenchyma and methods of hilar approach, chemotherapy, and complication follow after that in numerical order. Current evidence regarding hepatectomy, especially focusing on perioperative procedures, is summarized here based on a review of RCTs excluding "small-scale" trials with sample numbers less than 50.
随机对照试验(RCTs)最近在肝脏外科领域以及其他外科领域中被积极开展。本文回顾了过去十年间调查肝切除术的随机对照试验,以提供肝脏外科领域的最新证据。超过半数的随机对照试验是在亚洲进行的,尤其是在日本和中国。关于肝脏缺血的随机对照试验开展得最为频繁,比如血管阻断程序以及针对缺血/再灌注损伤的预防措施。关于手术程序的随机对照试验按数字顺序依次包括肝实质离断器械、肝门入路方法、化疗以及之后的并发症随访。基于对样本数量少于50的“小规模”试验的排除,本文通过对随机对照试验的回顾总结了目前关于肝切除术的证据,尤其侧重于围手术期程序。