中国实用外科杂志

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腹腔镜手术治疗复发性肝癌的价值及评价

张    磊,陈亚进   

  1. 中山大学孙逸仙纪念医院肝胆外科,广东广州510120
  • 出版日期:2019-10-01 发布日期:2019-10-10

  • Online:2019-10-01 Published:2019-10-10

摘要:

复发性肝癌再次切除率低,原手术导致的腹腔粘连及解剖变异等增加了手术难度及风险,使得复发性肝癌再次切除的微创化进程非常缓慢。近年来,随着腹腔镜设备的更新及手术经验的积累,国内外开始对腹腔镜下复发性肝癌再次切除进行初步探索。对于经过严格适应证选择的病人,腹腔镜再次肝切除能够显著降低围手术期并发症发生率,且达到与开腹手术相似的生存效果。但由于该治疗方式目前仍处于探索阶段,建议仅在有丰富开腹和腹腔镜肝切除经验的医疗中心对严格选择的病例实施。仍需高质量的临床研究推动其规范化开展。

关键词: 腹腔镜, 复发性肝癌, 肝切除

Abstract:

Value and evaluation of laparoscopic surgery for recurrent hepatocellular carcinoma        ZHANG Lei,CHEN Ya-jin. Department of Hepatobiliary Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China
Corresponding author:CHEN Ya-jin,E-mail:cyj0509@126.com
Abstract    The low resectability rate of recurrent hepatocellular carcinoma,abdominal adhesion and anatomical variation caused by the original hepatectomy increase the difficulty and risk of liver re-resection,which hampers the development of minimally invasive management of posthepatectomy hepatocellular carcinoma recurrence. In recent years,with the update of laparoscopic equipment and the accumulation of surgeon experience,preliminary exploration of laparoscopic liver re-resection for patients with posthepatectomy hepatocellular carcinoma recurrence has begun. In patients with strict indications,laparoscopic re-resection can significantly reduce the incidence of perioperative complications and achieve similar survival results as the open surgery.  However,as the treatment is still in the exploratory stage,it is recommended to perform only under the strict case selection of medical centers with rich experience in open and laparoscopic liver resection. High quality clinical research is still needed to promote its standardization.

Key words: laparoscopy, recurrent hepatocellular carcinoma, hepatectomy