自1888年Langenbuch為肝臟腫瘤患者施行首例肝切除術(shù)后,肝臟外科至今已有一百多年歷史。我國(guó)的肝臟外科經(jīng)歷了20世紀(jì)50年代的大肝癌的規(guī)則性切除,60年代的肝移植,70年代的小肝癌的局部切除,80年代的復(fù)發(fā)肝癌的再切除和肝癌的二期切除,90年代確立的肝癌綜合治療以及21世紀(jì)的肝癌轉(zhuǎn)移、復(fù)發(fā)的防治研究階段。腫瘤的早期發(fā)現(xiàn)和以手術(shù)切除為主的綜合治療大大提高了肝癌患者的生存率,手術(shù)切除仍是獲得長(zhǎng)期生存的最重要手段。隨著肝臟解剖學(xué)的發(fā)展、影像學(xué)技術(shù)的進(jìn)步、術(shù)中超聲的應(yīng)用、肝儲(chǔ)備功能評(píng)估方法的改進(jìn)、圍手術(shù)期處理的完善、手術(shù)技術(shù)的進(jìn)步以及手術(shù)器械的發(fā)展,使肝切除手術(shù)的死亡率和術(shù)后并發(fā)癥發(fā)生率大大降低。近年來(lái),微創(chuàng)觀念和微創(chuàng)外科技術(shù)的興起以及肝移植特別是活體肝移植(LDLT)的蓬勃開(kāi)展,對(duì)傳統(tǒng)的肝切除術(shù)造成巨大沖擊,也因此促使了肝切除術(shù)的不斷發(fā)展、豐富和完善。如何安全、徹底地切除肝臟病灶,同時(shí)保留充足的功能性肝組織,成為外科醫(yī)師面臨的新挑戰(zhàn)。................
引用本文: 樊嘉,黃成. 原發(fā)性肝癌外科治療的進(jìn)展. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009, 16(4): 257-260. doi: 復(fù)制
1. | 樊嘉, 黃成. 肝癌外科治療進(jìn)展 [J] . 四川醫(yī)學(xué), 2005; 26(3): 273275. |
2. | Llovet JM, Bruix J. Novel advancements in the management of hepatocellular carcinoma in 2008 [J] . J Hepatol, 2008; 48 Suppl 1: S20S37.[3] Elias D, Lasser P, Debaene B, et al . Intermittent vascular exclusion of the liver (without vena cava clamping) during major hepatectomy [J]. Br J Surg, 1995; 82(11): 15351539. |
3. | 文天夫, 嚴(yán)律南. 肝切除術(shù)中肝臟血流阻斷技術(shù)的研究進(jìn)展 [J] . 中國(guó)普外科基礎(chǔ)與臨床雜志, 2008; 15(4): 209302. |
4. | Belghiti J, Guevara OA, Noun R, et al . Liver hanging maneuver: a safe approach to right hepatectomy without liver mobilization [J] . J Am Coll Surg, 2001; 193(1): 109111. |
5. | Tepetes K, Christodoulidis G, Spyridakis EM, et al . Tissue preserving hepatectomy by a vessel sealing device [J]. J Surg Oncol, 2008; 97(2): 165168. |
6. | Sasaki A, Nitta H, Otsuka K, et al . Tenyear experience of totally laparoscopic liver resection in a single institution [J] . Br J Surg, 2009; 96(3): 274279. |
7. | Sugawara Y, Kokudo N. Surgical treatment of hepatocellular carcinoma: comparison of resection and transplantation [J] . Oncology, 2008; 75 Suppl 1: 119123. |
8. | 樊嘉, 周儉, 徐泱, 等. 肝癌肝移植適應(yīng)證的選擇: 上海復(fù)旦標(biāo)準(zhǔn) [J] . 中華醫(yī)學(xué)雜志, 2006; 86(18): 12271231. |
9. | Mazzaferro V, Llovet JM, Miceli R, et al . Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis [J] . Lancet Oncol, 2009; 10(1): 3543. |
- 1. 樊嘉, 黃成. 肝癌外科治療進(jìn)展 [J] . 四川醫(yī)學(xué), 2005; 26(3): 273275.
- 2. Llovet JM, Bruix J. Novel advancements in the management of hepatocellular carcinoma in 2008 [J] . J Hepatol, 2008; 48 Suppl 1: S20S37.[3] Elias D, Lasser P, Debaene B, et al . Intermittent vascular exclusion of the liver (without vena cava clamping) during major hepatectomy [J]. Br J Surg, 1995; 82(11): 15351539.
- 3. 文天夫, 嚴(yán)律南. 肝切除術(shù)中肝臟血流阻斷技術(shù)的研究進(jìn)展 [J] . 中國(guó)普外科基礎(chǔ)與臨床雜志, 2008; 15(4): 209302.
- 4. Belghiti J, Guevara OA, Noun R, et al . Liver hanging maneuver: a safe approach to right hepatectomy without liver mobilization [J] . J Am Coll Surg, 2001; 193(1): 109111.
- 5. Tepetes K, Christodoulidis G, Spyridakis EM, et al . Tissue preserving hepatectomy by a vessel sealing device [J]. J Surg Oncol, 2008; 97(2): 165168.
- 6. Sasaki A, Nitta H, Otsuka K, et al . Tenyear experience of totally laparoscopic liver resection in a single institution [J] . Br J Surg, 2009; 96(3): 274279.
- 7. Sugawara Y, Kokudo N. Surgical treatment of hepatocellular carcinoma: comparison of resection and transplantation [J] . Oncology, 2008; 75 Suppl 1: 119123.
- 8. 樊嘉, 周儉, 徐泱, 等. 肝癌肝移植適應(yīng)證的選擇: 上海復(fù)旦標(biāo)準(zhǔn) [J] . 中華醫(yī)學(xué)雜志, 2006; 86(18): 12271231.
- 9. Mazzaferro V, Llovet JM, Miceli R, et al . Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis [J] . Lancet Oncol, 2009; 10(1): 3543.