Liver Surgery Unit, Third Department of General Surgery, University of Milan, IRCCS Istituto Clinico Humanitas, Rozzano, Italy.
Dig Surg. 2011;28(2):109-13. doi: 10.1159/000323819. Epub 2011 Apr 29.
In the case of tumors in contact with or invading the middle hepatic vein (MHV) at the hepatocaval confluence, extended right hepatectomy or mesohepatectomy is usually recommended. Major or extended hepatectomy is associated with significant rates of morbidity and mortality, and a more conservative approach would be desirable. Thus, we developed a new conservative operation, the so-called mini-mesohepatectomy that, in some specific circumstances, allowed the en-bloc resection of segment 8, segment 4-sup and the MHV at the hepatocaval confluence and at the same time preservation of the remaining parenchyma of the right anterior section and left median section drained by the MHV. The present work describes the rationale, indications, as well as the surgical technique of this new operation which we believe should be part of the armamentarium of the modern hepatic surgeon, and will probably limit the need for a formal mesohepatectomy.
在肝静脉中肝段（MHV）与肿瘤接触或侵犯的情况下，通常建议进行扩大右半肝切除术或中肝切除术。大或扩大肝切除术与显著的发病率和死亡率相关，因此更保守的方法是可取的。因此，我们开发了一种新的保守手术，即所谓的迷你中肝切除术，在某些特定情况下，可以整块切除第 8 段、第 4 段-上段和 MHV 在肝静脉汇合处，同时保留由 MHV 引流的右前叶和左中叶剩余实质。本工作描述了这种新手术的原理、适应证以及手术技术，我们认为它应该成为现代肝脏外科医生的手术工具之一，并且可能会限制对正式中肝切除术的需求。
