Guro Hanisah, Cho Jai Young, Han Ho-Seong, Yoon Yoo-Seok, Choi YoungRok, Periyasamy Mohan
Department of Surgery, Amai Pakpak Medical Center, Marawi City, Philippines.
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Clin Mol Hepatol. 2016 Jun;22(2):212-8. doi: 10.3350/cmh.2016.0026. Epub 2016 Jun 15.
Laparoscopic liver resection (LLR) is becoming widely accepted for the treatment of hepatocellular carcinoma (HCC). Laparoscopic left lateral sectionectomy and minor laparoscopic liver resection are now considered standard approaches, especially for tumors located in the anterolateral segments of the liver. Laparoscopic left lateral sectionectomy in adult donors is also gaining acceptance for child liver transplantation in many centers. Major LLRs, including left hepatectomy and right hepatectomy, have been recently attempted. Laparoscopic donor hepatectomy is becoming more popular owing to increasing demand from young living donors who appreciate its minimal invasiveness and excellent cosmetic outcomes. Several centers have performed total laparoscopic donor right hepatectomy in adult-to-adult living donor liver transplantation. Many meta-analyses have shown that LLR is better than open liver resection in terms of short-term outcomes, principally cosmetic outcomes. Although no randomized control trials have compared LLR with open liver resection, the long-term oncologic outcomes were similar for both procedures in recent case-matched studies.
腹腔镜肝切除术(LLR)在肝细胞癌(HCC)治疗中越来越被广泛接受。腹腔镜左外侧叶切除术和小型腹腔镜肝切除术目前被视为标准术式,特别是对于位于肝脏前外侧段的肿瘤。成人供体的腹腔镜左外侧叶切除术在许多中心也越来越多地被用于儿童肝移植。包括左肝切除术和右肝切除术在内的大型LLR近来也已尝试开展。由于越来越多年轻的活体供体青睐其微创性和出色的美容效果,腹腔镜供体肝切除术越来越受欢迎。多个中心已在成人对成人活体供肝移植中开展了完全腹腔镜供体右肝切除术。多项荟萃分析表明,就短期疗效而言,主要是美容效果,LLR优于开腹肝切除术。尽管尚无随机对照试验将LLR与开腹肝切除术进行比较,但在近期的病例匹配研究中,两种手术的长期肿瘤学疗效相似。