中国实用外科杂志

中国实用外科杂志 ›› 2012, Vol. 32 ›› Issue (10): 829-832.

• 专题笔谈 • 上一篇    下一篇

肝癌治疗方法选择与肝癌转移及复发

闫    军，别    平   

  1. 第三军医大学西南医院全军肝胆外科研究所，重庆400038
  • 出版日期:2012-10-01 发布日期:2012-09-28

  • Online:2012-10-01 Published:2012-09-28

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摘要：

肿瘤复发是肝癌切除术后远期死亡的主要因素。手术方式的选择及术中操作对于肿瘤复发具有重要影响。解剖性肝切除符合肿瘤肝内转移的解剖学基础；选取适当的病例采用腹腔镜肝切除术，具有微创的意义；射频消融可作为直径3 cm以下肝癌的一线治疗手段，并是肝切除术中处理肝脏深部多发小病灶的有效方法。为避免手术挤压所造成的肿瘤播散，前入路肝切除术是一项有效的方式；肝门阻断有潜在增加肝癌复发的风险，应尽量采取多种方法避免或减少肝门阻断的时间。对于非根治性切除或进展期肝癌，术后经肝动脉化疗栓塞（TACE）有可能改善其预后。

关键词: 肝癌, 术后复发, 肝切除术

Abstract:

Option of surgical treatments for liver cancer and recurrence        YAN Jun，BIE Ping. Institute of Hepatobiliary Surgery，Southwest Hospital，the Third Military Medical University，Chongqing 400038，China
Corresponding author：BIE Ping，E-mail: bieping@medmail.com.cnAbstrac
Abstract    Tumor recurrence is a major factor in liver cancer long-term postoperative death. The choice of surgical approaches and surgical operation had an important influence for tumor recurrence. Precise anatomical liver resection conforms to the anatomical principle of tumor intrahepatic metastasis. Laparoscopic liver resection is micro invasive for appropriate cases. Radiofrequency ablation can be used as a method of first-line treatment of liver cancer that small than 3cm in diameter, which is an effective adjunct for liver resection. The anterior approach hepatectomy is an effective method for avoiding tumor spread that caused by surgical squeeze. Pringle’s maneuver might increase the risk of tumor recurrence. So it should try to adopt various methods to prevent or reduce the hepatic inflow occlusion. Postoperative TACE might improve the prognosis for non-radical resection of advanced liver cancer.

Key words: liver cancer, postoperative recurrence, hepatectomy