Yamazaki Shintaro, Takayama Tadatoshi
Department of Digestive Surgery Nihon University School of Medicine Tokyo Japan.
Ann Gastroenterol Surg. 2019 Feb 15;3(2):146-159. doi: 10.1002/ags3.12233. eCollection 2019 Mar.
Liver resection is one of the main treatment strategies for liver malignancies. Mortality and morbidity of liver surgery has improved significantly with progress in selection criteria, development of operative procedures and improvements in perioperative management. Safe liver resection has thus become more available worldwide. We have identified four current topics related to liver resection (anatomical liver resection, laparoscopic liver resection, staged liver resection and chemotherapy-induced liver injury). The balance between treatment effect and patient safety needs to be considered when planning liver resection. Progress in this area has been rapid thanks to the efforts of many surgeons, and outcomes have improved significantly as a result. These topics remain to be solved and more robust evidence is needed. Precise selection of the optimal procedure and risk evaluation should be standardized with further development of each topic. The present article reviews these four current topics with a focus on safety and efficacy in recent series.
肝切除术是肝脏恶性肿瘤的主要治疗策略之一。随着选择标准的进步、手术方法的发展以及围手术期管理的改善，肝脏手术的死亡率和发病率已显著降低。因此，安全的肝切除术在全球范围内变得更加可行。我们确定了与肝切除术相关的四个当前主题（解剖性肝切除术、腹腔镜肝切除术、分期肝切除术和化疗引起的肝损伤）。在规划肝切除手术时，需要考虑治疗效果与患者安全之间的平衡。由于许多外科医生的努力，该领域进展迅速，结果也显著改善。这些主题仍有待解决，需要更有力的证据。随着每个主题的进一步发展，应规范最佳手术的精确选择和风险评估。本文回顾了这四个当前主题，重点关注近期系列研究中的安全性和有效性。
