• 復(fù)旦大學(xué)附屬中山醫(yī)院肝臟外科,肝移植中心,肝癌研究所(上海200032);

自1888年Langenbuch為肝臟腫瘤患者施行首例肝切除術(shù)后,肝臟外科至今已有一百多年歷史。我國(guó)的肝臟外科經(jīng)歷了20世紀(jì)50年代的大肝癌的規(guī)則性切除,60年代的肝移植,70年代的小肝癌的局部切除,80年代的復(fù)發(fā)肝癌的再切除和肝癌的二期切除,90年代確立的肝癌綜合治療以及21世紀(jì)的肝癌轉(zhuǎn)移、復(fù)發(fā)的防治研究階段。腫瘤的早期發(fā)現(xiàn)和以手術(shù)切除為主的綜合治療大大提高了肝癌患者的生存率,手術(shù)切除仍是獲得長(zhǎng)期生存的最重要手段。隨著肝臟解剖學(xué)的發(fā)展、影像學(xué)技術(shù)的進(jìn)步、術(shù)中超聲的應(yīng)用、肝儲(chǔ)備功能評(píng)估方法的改進(jìn)、圍手術(shù)期處理的完善、手術(shù)技術(shù)的進(jìn)步以及手術(shù)器械的發(fā)展,使肝切除手術(shù)的死亡率和術(shù)后并發(fā)癥發(fā)生率大大降低。近年來(lái),微創(chuàng)觀念和微創(chuàng)外科技術(shù)的興起以及肝移植特別是活體肝移植(LDLT)的蓬勃開(kāi)展,對(duì)傳統(tǒng)的肝切除術(shù)造成巨大沖擊,也因此促使了肝切除術(shù)的不斷發(fā)展、豐富和完善。如何安全、徹底地切除肝臟病灶,同時(shí)保留充足的功能性肝組織,成為外科醫(yī)師面臨的新挑戰(zhàn)。................

引用本文: 樊嘉,黃成. 原發(fā)性肝癌外科治療的進(jìn)展. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009, 16(4): 257-260. doi: 復(fù)制

1. 樊嘉, 黃成. 肝癌外科治療進(jìn)展 [J] . 四川醫(yī)學(xué), 2005; 26(3): 273275.
2. Llovet JM, Bruix J. Novel advancements in the management of hepatocellular carcinoma in 2008  [J] . J Hepatol, 2008; 48 Suppl 1: S20S37.[3] Elias D, Lasser P, Debaene B, et al . Intermittent vascular exclusion of the liver (without vena cava clamping) during major hepatectomy [J]. Br J Surg, 1995; 82(11): 15351539.
3. 文天夫, 嚴(yán)律南. 肝切除術(shù)中肝臟血流阻斷技術(shù)的研究進(jìn)展 [J] . 中國(guó)普外科基礎(chǔ)與臨床雜志, 2008; 15(4): 209302.
4. Belghiti J, Guevara OA, Noun R, et al . Liver hanging maneuver: a safe approach to right hepatectomy without liver mobilization [J] . J Am Coll Surg, 2001; 193(1): 109111.
5. Tepetes K, Christodoulidis G, Spyridakis EM, et al . Tissue preserving hepatectomy by a vessel sealing device [J]. J Surg Oncol, 2008; 97(2): 165168.
6. Sasaki A, Nitta H, Otsuka K, et al . Tenyear experience of totally laparoscopic liver resection in a single institution [J] . Br J Surg, 2009; 96(3): 274279.
7. Sugawara Y, Kokudo N. Surgical treatment of hepatocellular carcinoma: comparison of resection and transplantation [J] . Oncology, 2008; 75 Suppl 1: 119123.
8. 樊嘉, 周儉, 徐泱, 等. 肝癌肝移植適應(yīng)證的選擇: 上海復(fù)旦標(biāo)準(zhǔn) [J] . 中華醫(yī)學(xué)雜志, 2006; 86(18): 12271231.
9. Mazzaferro V, Llovet JM, Miceli R, et al . Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis [J] . Lancet Oncol, 2009; 10(1): 3543.
  1. 1. 樊嘉, 黃成. 肝癌外科治療進(jìn)展 [J] . 四川醫(yī)學(xué), 2005; 26(3): 273275.
  2. 2. Llovet JM, Bruix J. Novel advancements in the management of hepatocellular carcinoma in 2008  [J] . J Hepatol, 2008; 48 Suppl 1: S20S37.[3] Elias D, Lasser P, Debaene B, et al . Intermittent vascular exclusion of the liver (without vena cava clamping) during major hepatectomy [J]. Br J Surg, 1995; 82(11): 15351539.
  3. 3. 文天夫, 嚴(yán)律南. 肝切除術(shù)中肝臟血流阻斷技術(shù)的研究進(jìn)展 [J] . 中國(guó)普外科基礎(chǔ)與臨床雜志, 2008; 15(4): 209302.
  4. 4. Belghiti J, Guevara OA, Noun R, et al . Liver hanging maneuver: a safe approach to right hepatectomy without liver mobilization [J] . J Am Coll Surg, 2001; 193(1): 109111.
  5. 5. Tepetes K, Christodoulidis G, Spyridakis EM, et al . Tissue preserving hepatectomy by a vessel sealing device [J]. J Surg Oncol, 2008; 97(2): 165168.
  6. 6. Sasaki A, Nitta H, Otsuka K, et al . Tenyear experience of totally laparoscopic liver resection in a single institution [J] . Br J Surg, 2009; 96(3): 274279.
  7. 7. Sugawara Y, Kokudo N. Surgical treatment of hepatocellular carcinoma: comparison of resection and transplantation [J] . Oncology, 2008; 75 Suppl 1: 119123.
  8. 8. 樊嘉, 周儉, 徐泱, 等. 肝癌肝移植適應(yīng)證的選擇: 上海復(fù)旦標(biāo)準(zhǔn) [J] . 中華醫(yī)學(xué)雜志, 2006; 86(18): 12271231.
  9. 9. Mazzaferro V, Llovet JM, Miceli R, et al . Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis [J] . Lancet Oncol, 2009; 10(1): 3543.