Abstract:

Influence of Intraoperative blood loss and ischemia-reperfusion injury induced on the prognosis of hepatocellular carcinoma patients        ZENG Yong，HUANG Ji-wei. West China Hospital，Sichuan University，Chengdu 610041，China
Corresponding author：ZENG Yong，E-mail：zengyong@
medmail.com.cn
Abstract    Ischemic reperfusion after blood flow occlusion has been bound to lead to an increased hepatic burden，concerned with delayed postoperative recovery of liver function，and threatened tumor recurrence and patient prognosis. We found that intermittent hepatic inflow occlusion exerted no adverse effect on the long-term survival of patients with hepatocellular carcinoma. Meanwhile，there was no significant difference in short-term or long-term oncologic outcome after selective or total inflow occlusion. Nowadays，more and more liver resections can be performed safely without hepatic occlusion. But we still suggest to put patient safety and radical resection of the tumor in the first place before perform non-inflow occlusion hepatectomy or minimally invasive surgeries. Because liver has a very high resistance to ischemia and hypoxia. Nevertheless，massive intraoperative bleeding and intraoperative blood transfusion were related with worsen long-term prognosis of cancer patients. Conclusively，Pringle inflow occlusion is feasible and worthy to be spread.

Key words: hepatectomy, ischemic-reperfusion, inflow occlusion

摘要：

入肝血流阻断对肝实质的缺血再灌注损伤及其对肿瘤病人预后的影响一直存在争议。笔者中心经验显示，间断入肝血流阻断对肝细胞癌病人的长期生存没有不利影响，全入肝血流阻断与选择性血流阻断的短期或长期肿瘤学结果差异无统计学意义。随着技术进步，越来越多的肝癌切除手术可在不阻断血流的情况下安全完成，但术中大量出血与术中输血均影响病人长期预后。肝脏有非常高的耐缺血、缺氧能力，因而应在病人的安全和根治性切除癌肿基础上考虑不阻断肝脏血流以及选择更微创的方式。全入肝血流阻断相较于选择性半肝阻断，更容易操作、创伤更小，更适合推广。

关键词: 肝切除术, 缺血再灌注, 入肝血流阻断