Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, W12 0NN, UK.
Front Med. 2011 Sep;5(3):271-6. doi: 10.1007/s11684-011-0148-4. Epub 2011 Oct 2.
Hepatocellular carcinoma (HCC) is the fifth most common neoplasm in the world, closely correlated with viral hepatitis and liver cirrhosis. The vast majority of HCC patients present at a late stage and are unsuitable for surgery due to limited liver functional reserve. Tumors can involve major vessels or hilar structures, necessitating major liver resection and/or rendering liver resection unfeasible. A series of new technologies have been developed to optimise HCC management. Stem cell therapy improves impaired liver functional reserve prior to liver resection. Intravascular radiofrequency ablation recanalises the portal vein invaded by tumour thrombus and endobiliary radiofrequency ablation restores and extends biliary patency of the bile duct invaded by malignancy. Laparoscopic radiofrequency assisted liver resection minimizes blood loss and avoids liver warm ischemia, while increasing parenchymal sparing. These benefits combined maximize the safety of liver resection.
肝细胞癌 (HCC) 是世界上第五种最常见的肿瘤，与病毒性肝炎和肝硬化密切相关。绝大多数 HCC 患者在晚期出现，由于肝脏储备功能有限，不适合手术。肿瘤可累及大血管或肝门结构，需要进行大肝切除术和/或使肝切除术不可行。一系列新技术的发展旨在优化 HCC 的管理。干细胞治疗可改善肝切除术前的肝功能储备。血管内射频消融可使肿瘤栓子侵犯的门静脉再通，经胆道射频消融可恢复和延长受恶性肿瘤侵犯的胆管的通畅性。腹腔镜下射频辅助肝切除术可最大限度地减少出血，避免肝脏热缺血，同时增加肝实质的保留。这些益处结合起来，使肝切除术的安全性最大化。
