Washington Cancer Institute, Washington Hospital Center, Washington, District of Columbia 20010, USA.
J Surg Oncol. 2010 Mar 1;101(3):251-2. doi: 10.1002/jso.21478.
Cancer dissemination on peritoneal surfaces can be treated by cytoreductive surgery and perioperative intraperitoneal chemotherapy. To maximize benefits a complete cancer removal precedes the chemotherapy treatments.
During cytoreductive surgical procedures a variable bridge of liver parenchyma that covers the round ligament of the liver was observed. This bridge of liver parenchyma is referred to as the pont hepatique (hepatic bridge). Failure to remove tumor nodules from beneath the pont hepatique will result in recurrent disease.
If the pont hepatique is opened as part of a cytoreductive procedure for peritoneal dissemination of cancer, cancer nodules will often be found beneath. These nodules can be removed using electrosurgical dissection taking care to avoid damage to the left hepatic artery.
Division of the pont hepatique and removal of cancer nodules around and on the round ligament will facilitate a complete cytoreduction.
腹膜表面的癌症扩散可以通过细胞减灭术和围手术期腹腔内化疗来治疗。为了最大限度地发挥疗效，在化疗治疗之前应进行彻底的癌症清除。
在细胞减灭手术过程中，观察到覆盖肝圆韧带的肝脏实质的可变桥。这个肝实质桥被称为肝桥（pont hepatique）。如果未能从肝桥下清除肿瘤结节，将导致疾病复发。
如果在治疗腹膜转移癌的细胞减灭术中打开肝桥，通常会发现下面有癌症结节。可以使用电外科解剖来切除这些结节，注意避免损伤左肝动脉。
切开肝桥并清除圆韧带周围和上面的癌症结节将有助于实现彻底的细胞减灭。
