中国实用外科杂志

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从肝脏精细解剖学分析肝细胞癌转化治疗后行肝切除术的难点与对策

赵    阳,戴朝六   

  1. 中国医科大学附属盛京医院普外科(肝胆脾外科),辽宁沈阳 110004
  • 出版日期:2025-08-01

  • Online:2025-08-01

摘要: 随着肝细胞癌综合治疗的发展,转化治疗为不可切除肝细胞癌病人提供了手术机会,但转化治疗后肝切除术面临肝脏细微解剖结构和全身状态改变的核心挑战。需从解剖学视角,系统分析转化治疗对肝脏解剖的影响及肝切除术的难点与对策,尤其是功能性剩余肝脏体积转化和肿瘤学转化治疗对全身及肝脏的影响。实行精准术前评估、优化手术时机、术中精细操作及多学科协作的综合策略,可提高手术安全性与肿瘤学疗效。

关键词: 肝细胞癌, 转化治疗, 肝脏, 精细解剖学

Abstract: With the development of comprehensive treatment for hepatocellular carcinoma, conversion therapy has provided surgical opportunities for patients with unresectable hepatocellular carcinoma; however, liver resection after conversion faces the core challenge of changes in the fine anatomical structure of the liver and systemic status. It is necessary to systematically analyze the impact of conversion therapy on hepatic anatomy, as well as the difficulties and countermeasures in liver resection, from the anatomical perspective, especially the impact of future liver remnant conversion and oncological conversion therapy on the whole body and the liver. Implementing the comprehensive strategy involving precise preoperative evaluation, optimization of surgical timing, intraoperative meticulous operation, and multidisciplinary collaboration is proposed, can enhance surgical safety and oncological efficacy.

Key words: hepatocellular carcinoma, conversion therapy, liver, fine anatomy