关键词: 原发性肝细胞癌, 腹腔镜肝切除术, 肿瘤学风险, R0切除, 肿瘤种植

Abstract: Laparoscopic hepatectomy for primary liver cancer: oncological risk and strategy        LIANG Xiao, YANG Zai-bo. Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China
Corresponding author: LIANG Xiao, E-mail: srrshlx@zju.edu.cn
Abstract    Primary liver cancer is the most common malignancy which liver resection is still the mainly curative approach. Laparoscopic surgery, with advantages like a minimal invasion, less intraoperative blood loss, and faster postoperative recovery, has been widely accepted as the standard of the treatment of primary liver cancer. The chance of R0 resection and the width of the surgical margin of laparoscopic hepatectomy(LH) is comparable with the open procedure, while the postoperative survival is even better. Despite a lack of palpation of the lesion to determine the margin of the tumor, with the advance in 3D reconstruction, laparoscopic ultrasound, and indocyanine green(ICG) fluorescence navigation, it is feasible to perform an R0 resection. It was considered that the use of CO2 pneumoperitoneum and harmonic scalpel may be associated with tumor spread, however, the evidence showed that tumor implants induced by LH were rare. Therefore, the oncological outcome of LH in treating primary liver cancer is acceptable with little risk of tumor spread.

Key words: primary liver cancer, laparoscopic hepatectomy, oncological risk, R0 resection, tumor implant