精准肝切除方式选择的挑战与思考  

Challenges and thoughts on precise hepatectomy

作　　者：姜洪池[1] 刘连新[1] 

机构地区：[1]哈尔滨医科大学附属第一医院肝脏外科、教育部肝脾外科重点实验室,150001

出　　处：《中华消化外科杂志》2011年第1期4-5,共2页Chinese Journal of Digestive Surgery

基　　金：基金项目：教育部新世纪优秀人才支持计划（NCET-06-0350）;黑龙江省杰出青年科学基金（JC200616）;黑龙江省高校科技创新团队建设计划资助（2009td06）

摘　　要：自范上达院士将精准肝切除的理念与技术应用于活体肝移植手术以来，这一理念立即吸引了外科医生的注意及兴趣。何故？精准肝切除是微创外科理念在肝脏外科领域的进一步深化和具体实施，而不是某一项具体的技术，也不能狭猫地理解为今日的肝切除是精准的，而往日传统的肝切除是粗糙的、创伤是巨大的。Precise hepatectomy is the application of minimally invasive concept in hepatic surgery. There are big challenges for surgeons to choose the proper approaches to achieve the aim of precise hepatectomy. How to choose thera- peutic strategy, chemotherapy, radiotherapy, liver transplanta- tion or radiofrequency ablation？ How to choose the operation type, laparoscopic surgery, transabdominal surgery or Da Vinci robot-assisted surgery？ How to choose the surgical instruments during hepatectomy？ Although answers for these questions are various, the principle is unchangeable, which is providing minimal injury, less blood loss, fast recovery, little expense and good prognosis. The concept of precise hepatectomy includes precise judgment of liver function and careful preparation before operation, and also the elaborate nursing and multi-disciplinary cooperation during operation, as well as the fast track surgery after operation. Precise hepatectomy requires surgeons take the safety and effectiveness of the operations into account, and the conditions of hospitals, the skills and experiences of the surgeons should also be evaluated before operation. Finally, the economic condition of the patients should be considered and proper application of advanced equipments should be emphasized.

关 键 词：精准肝切除 挑战 思考 

分 类 号：R657.3[医药卫生—外科学]