Department of Surgery, Queen Mary Hospital, The University of Hong Kong, China.
Semin Liver Dis. 2013 Aug;33(3):273-81. doi: 10.1055/s-0033-1351782. Epub 2013 Aug 13.
Liver resection is the treatment of choice and standard of care in patients with hepatocellular carcinoma (HCC). The ultimate goal of liver resection in HCC patients is to resect primary tumor with an adequate margin while preserving as much functional liver parenchyma as possible. Tremendous improvements in perioperative outcomes after liver resection have been achieved in the past three decades. The overall and disease-free survival rates have also improved. Liver resection is feasible and safe even in cirrhotic patients. This is a result of more accurate preoperative evaluation of liver function, the ability to manipulate future liver remnant volume, the use of anatomical resection and an anterior approach, meticulous surgical techniques to achieve bloodless liver resection, and better perioperative care. The purpose of this review is to highlight the importance of different resection strategies for HCC that in turn have contributed to the safety and improvement in long-term outcomes after liver resection.
肝切除术是治疗肝细胞癌 (HCC) 的首选方法和标准治疗方法。 HCC 患者肝切除术的最终目标是在尽可能保留更多功能性肝实质的同时切除原发性肿瘤。在过去的三十年中，肝切除术后的围手术期结果取得了巨大的改善。总体生存率和无病生存率也有所提高。即使在肝硬化患者中，肝切除术也是可行且安全的。这是由于术前对肝功能进行了更准确的评估，能够操纵剩余肝体积，采用解剖性切除术和前入路，精细的手术技术实现无血肝切除，以及更好的围手术期护理。本文的目的是强调不同 HCC 切除术策略的重要性，这反过来又有助于提高肝切除术后的安全性和长期效果。
