Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China.
Semin Liver Dis. 2013 Aug;33(3):189-203. doi: 10.1055/s-0033-1351781. Epub 2013 Aug 13.
Continuous theoretical and technological progress in the face of increasing expectations for quality health care has transformed the surgical paradigm. The authors systematically review these historical trends and propose the novel paradigm of "precision surgery," featuring certainty-based practice to ensure the best result for each patient with multiobjective optimization of therapeutic effectiveness, surgical safety, and minimal invasiveness. The main characteristics of precision surgery may be summarized as determinacy, predictability, controllability, integration, standardization, and individualization. The strategy of precision in liver surgery is to seek a balance of maximizing the removal of the target lesion, while maximizing the functional liver remnant and minimizing surgical invasiveness. In this article, the authors demonstrate the application of precision approaches in specific settings in complex liver surgery. They propose that the concept of precision surgery should be considered for wider application in liver surgery and other fields as a step toward the ultimate goal of perfect surgery.
面对日益增长的高质量医疗保健期望，持续的理论和技术进步已经改变了外科手术模式。作者系统地回顾了这些历史趋势，并提出了“精准外科”的新范式，其以基于确定性的实践为特色，旨在通过治疗效果、手术安全性和微创性的多目标优化，为每个患者确保最佳结果。精准外科的主要特点可以概括为确定性、可预测性、可控性、整体性、标准化和个体化。肝脏外科精准策略的目标是寻求在最大限度地切除目标病变的同时，最大化保留功能性肝组织和最小化手术侵袭性之间的平衡。在本文中，作者展示了精准方法在复杂肝脏手术中的具体应用场景。他们提出，精准外科的概念应该在肝脏外科和其他领域得到更广泛的应用，以实现完美手术的最终目标。
