重视腹腔镜肝切除手术的安全性  

Prioritize the safety of laparoscopic liver resection

作　　者：陈亚进[1] 周睿 CHEN Ya-jin;ZHOU Rui(Department of Hepatobiliary Surgery,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院肝胆外科,广东广州510120

出　　处：《中国实用外科杂志》2022年第9期965-969,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.81972263)。

摘　　要：腹腔镜肝切除术治疗肝脏良恶性肿瘤的疗效已被广泛认可。然而,由于肝脏解剖变异多,腹腔镜操作复杂、难度较大的原因,腹腔镜肝切除安全性问题一直是制约其进一步发展和普及的瓶颈所在。在精准肝切除理念快速发展的时代,把握“肿瘤、解剖流域平面及重要脉管的可视化”、“围手术期肝功能、储备功能及剩余肝脏体积评估的可量化”、“术中切缘、出血、损伤及功能的可控化”、“复杂腹腔镜肝切除流程的标准化”4个关键要素,兼顾肿瘤学和外科学的治疗原则,制定同质化的规范术式,是安全有效开展腹腔镜肝切除术的关键。The efficacy of laparoscopic hepatectomy in the treatment of benign and malignant liver tumors has been widely recognized.However,because of the large variation of liver anatomy and the complication and difficulty of laparoscopic surgery,the safety of laparoscopic liver resection has always been a bottleneck restricting its further development and popularization.In the era of precise liver resection,the key to performing laparoscopic liver resection safely and effectively is to grasp 4 key elements--"the visualization of tumor,anatomical plane and important vessels","the quantification of perioperative liver function,reserve function and FLR assessment","the controllability of surgical margin,bleeding,injury and function"and"the standardization of complex laparoscopic liver resection procedures"to combine the treatment principles of oncology with surgery,and to formulate homogeneous standardized surgical procedures.

关 键 词：腹腔镜肝切除术 安全性 肝肿瘤 精准外科 

分 类 号：R6[医药卫生—外科学]