门静脉流域解剖性肝切除治疗肝细胞癌的理论与技术实践  

Theory and technical practice of anatomic liver resection based on portal territory for the treatment of hepatocellular carcinoma

作　　者：曹君[1] 王宏光 梁霄[3] 李建伟 成伟[5] 陈亚进[1] Cao Jun;Wang Hongguang;Liang Xiao;Li Jianwei;Cheng Wei;Chen Yajin(Department of Hepatobiliary Surgery,Sun Yat‐Sen Memorial Hospital,Sun Yat‐Sen University,Guangzhou 510120,China;Department of Hepatobiliary Surgery,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of General Surgery,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310016,China;Depart-ment of Hepatobiliary Surgery,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Department of Hepatobiliary and Pancreatic Surgery,Hunan Provincial People′s Hospital,Changsha 410005,China)

机构地区：[1]中山大学孙逸仙纪念医院肝胆外科,广州510120 [2]中国医学科学院北京协和医学院肿瘤医院肝胆外科,北京100021 [3]浙江大学医学院附属邵逸夫医院普通外科,杭州310016 [4]陆军军医大学第一附属医院肝胆外科,重庆400038 [5]湖南省人民医院肝胆胰外科,长沙410005

出　　处：《中华消化外科杂志》2022年第5期591-597,共7页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(81972263)。

摘　　要：解剖性肝切除旨在对荷瘤门静脉流域进行系统性切除,以提高肝细胞癌手术疗效,但由于传统理论和临床实践存在偏差,其肿瘤学疗效尚存争议。门静脉流域解剖性肝切除(PT-AR)基于真实门静脉流域分析进行手术规划,以荧光染色引导荷瘤门静脉流域切除同时,显露代表性流域间静脉,实现完整切除荷瘤门静脉流域同时可保证剩余肝脏完整功能。PT-AR基于经典解剖性肝切除核心理论,从技术层面修正经典解剖性肝切除理论与临床实践之间的偏差,有望更好实现肝细胞癌肿瘤学疗效。Anatomic resection aims to improve the surgical efficacy of hepatocellular carcinoma by systematic resection of portal territory.However,due to its deviation of traditional theory and practice,the oncology effect is questionable.Anatomic resection based on portal territory(PT-AR)is planned by the analysis of real portal vein territory,and performed complete resection of tumor-bearing portal territory by fluorescent guidance,while exposing typical inter-territory hepatic vein,so as to ensure the complete function of future liver remnant.PT-AR is based on the core theory of classical anatomic resection,which will correct the deviation of traditional theory and practice from the technical level,so as to lead a better surgical oncology outcomes for hepatocellular carcinoma.

关 键 词：肝肿瘤 门静脉流域 解剖性肝切除 门静脉流域解剖性肝切除 腹腔镜检查 

分 类 号：R735.7[医药卫生—肿瘤]