Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA.
J Surg Oncol. 2010 Jun 15;101(8):745-54. doi: 10.1002/jso.21506.
Advances in diagnostic, anesthetic, and surgical techniques have led to significant reductions in perioperative morbidity and mortality. The preoperative factors that have been of particular importance are a careful evaluation of hepatic function and of the predicted future liver remnant (FLR) volume prior to a decision on the feasibility of resection. Better patient selection, increased understanding of the liver anatomy leading to anatomical resections has together led to marked improvement in outcomes. In this article, we discuss the pre- and intraoperative factors, which have evolved in the last decade influencing the trend towards increased safety. We also share our technique of liver resection.
诊断、麻醉和手术技术的进步显著降低了围手术期的发病率和死亡率。术前特别重要的因素是在决定切除的可行性之前,仔细评估肝功能和预测的剩余肝(FLR)体积。更好的患者选择,对肝脏解剖结构的深入了解导致了解剖性切除术,这共同导致了结果的显著改善。在本文中,我们讨论了过去十年中影响安全性提高趋势的术前和术中因素。我们还分享了我们的肝切除术技术。