腹腔镜肝切除:解剖性与非解剖性利弊之我见
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摘要
随着腹腔镜手术器械和技术的不断进步,腹腔镜肝切除技术在肝脏良恶性疾病的治疗和肝移植供肝的切取中得到越来越多的应用。依据是否预先解剖和阻断预切除肝脏的入肝和(或)出肝血流,腹腔镜肝切除可分为解剖性和非解剖性肝切除。二者具有各自的适应证和优缺点。本文结合文献和个人经验,对腹腔镜解剖性与非解剖性肝切除的利弊进行论述与讨论。
With the continuous improvement of laparoscopic instruments and techniques, laparoscopic hepatectomy has been applied more and more in the treatments for benign and malignant liver diseases, as well as the harvest of donor liver for liver transplantation. Laparoscopic hepatectomy could be divided into anatomic and non-anatomic hepatectomy, depending on whether the liver is pre-dissected or blocked from inflow and/or outflow, with their own indications, advantages and disadvantages. Based on literature and initial experience, the advantages and disadvantages of laparoscopic anatomic and non-anatomic liver resection were reviewed in this paper.
With the continuous improvement of laparoscopic instruments and techniques, laparoscopic hepatectomy has been applied more and more in the treatments for benign and malignant liver diseases, as well as the harvest of donor liver for liver transplantation. Laparoscopic hepatectomy could be divided into anatomic and non-anatomic hepatectomy, depending on whether the liver is pre-dissected or blocked from inflow and/or outflow, with their own indications, advantages and disadvantages. Based on literature and initial experience, the advantages and disadvantages of laparoscopic anatomic and non-anatomic liver resection were reviewed in this paper.
引文
[1] 沈锋.腹腔镜肝叶切除的纷争[J/CD].中华普外科手术学杂志(电子版),2018,12(5):368-371.
[2] Takahara T,Wakabayashi G,Konno H,et al.Comparison of laparoscopic major hepatectomy with propensity score matched open cases from the National Clinical Database in Japan [J].J Hepatobiliary Pancreat Sci,2016,23(11):721-734.
[3] 张红卫,李闻达,曹君,等.3D腹腔镜下解剖性肝切除术治疗肝脏肿瘤的应用价值[J/CD].中华肝脏外科手术学电子杂志,2014,3(3):152-156.
[4] Ahn S,Cho A,Kim EK,et al.Favorable Long-Term Oncologic Outcomes of Hepatocellular Carcinoma Following Laparoscopic Liver Resection [J].J Laparoendosc Adv Surg Tech,2016,26(6):447-452.
[5] Cheng Y,Zhang L,Li H,et al.Laparoscopic versus open liver resection for colorectal liver metastases:a systematic review [J].J Surg Res,2017,220:234-246.
[6] Jarufe N,Figueroa E,Munoz C,et al.Anatomic hepatectomy as a definitive treatment for hepatolithiasis:a cohort study [J].HPB (Oxford),2012,14(9):604-610.
[7] 张万广,柴松山.不同肝血流阻断方式在腹腔镜肝切除术中的应用评价 [J].中国实用外科杂志,2017,37(5):469-473.
[8] Lee KF,Wong J,Cheung SYS,et al.Does Intermittent Pringle Maneuver Increase Postoperative Complications After Hepatectomy for Hepatocellular Carcinoma?A Randomized Controlled Trial [J].World J Surg,2018,42(10):3302-3311.
[9] 戴朝六,徐锋,金添强.腹腔镜解剖性肝切除的利与弊[J/CD].中华普外科手术学杂志(电子版),2018,12(5):364-367.
[10] Moris D,Tsilimigras DI,Kostakis ID,et al.Anatomic versus non-anatomic resection for hepatocellular carcinoma:A systematic review and meta-analysis [J].Eur J Surg Oncol,2018,44(7):927-938.
[11] Otsuka Y,Katagiri T,Ishii J,et al.Gas embolism in laparoscopic hepatectomy:what is the optimal pneumoperitoneal pressure for laparoscopic major hepatectomy?[J].J Hepatobiliary Pancreat Sci,2013,20(2):137-140.
[12] Ueno M,Hayami S,Sonomura T,et al.Indocyanine green fluorescence imaging techniques and interventional radiology during laparoscopic anatomical liver resection (with video) [J].Surg Endosc,2018,32(2):1051-1055.
[13] 王宏光,许寅喆,陈明易,等.吲哚菁绿荧光融合影像引导在腹腔镜解剖性肝切除术中的应用价值 [J].中华消化外科杂志,2017,16(4):405-409.
[14] Yamamoto Y,Ikoma H,Morimura R,et al.Clinical analysis of anatomical resection for the treatment of hepatocellular carcinoma based on the stratification of liver function [J].World J Surg,2014,38(5):1154-1163.
[15] Kang KJ,Ahn KS.Anatomical resection of hepatocellular carcinoma:A critical review of the procedure and its benefits on survival [J].World J Gastroenterol,2017,23(7):1139-1146.
[16] Huang X,Lu S.A Meta-analysis comparing the effect of anatomical resection vs.non-anatomical resection on the long-term outcomes for patients undergoing hepatic resection for hepatocellular carcinoma [J].HPB (Oxford),2017,19(10):843-849.
[17] Kaibori M,Kon M,Kitawaki T,et al.Comparison of anatomic and non-anatomic hepatic resection for hepatocellular carcinoma [J].J Hepatobiliary Pancreat Sci,2017,24(11):616-626.
[18] 翟志超,任为正,刘志伟,等.解剖性与非解剖性肝切除治疗原发性肝癌远期疗效的比较[J].中华肝胆外科杂志,2017,23(11):771-775.
[19] 张雅敏,王建.解剖性肝切除与非解剖性肝切除对肝癌预后影响的研究进展 [J].中华外科杂志,2016,54(12):947-950.
[2] Takahara T,Wakabayashi G,Konno H,et al.Comparison of laparoscopic major hepatectomy with propensity score matched open cases from the National Clinical Database in Japan [J].J Hepatobiliary Pancreat Sci,2016,23(11):721-734.
[3] 张红卫,李闻达,曹君,等.3D腹腔镜下解剖性肝切除术治疗肝脏肿瘤的应用价值[J/CD].中华肝脏外科手术学电子杂志,2014,3(3):152-156.
[4] Ahn S,Cho A,Kim EK,et al.Favorable Long-Term Oncologic Outcomes of Hepatocellular Carcinoma Following Laparoscopic Liver Resection [J].J Laparoendosc Adv Surg Tech,2016,26(6):447-452.
[5] Cheng Y,Zhang L,Li H,et al.Laparoscopic versus open liver resection for colorectal liver metastases:a systematic review [J].J Surg Res,2017,220:234-246.
[6] Jarufe N,Figueroa E,Munoz C,et al.Anatomic hepatectomy as a definitive treatment for hepatolithiasis:a cohort study [J].HPB (Oxford),2012,14(9):604-610.
[7] 张万广,柴松山.不同肝血流阻断方式在腹腔镜肝切除术中的应用评价 [J].中国实用外科杂志,2017,37(5):469-473.
[8] Lee KF,Wong J,Cheung SYS,et al.Does Intermittent Pringle Maneuver Increase Postoperative Complications After Hepatectomy for Hepatocellular Carcinoma?A Randomized Controlled Trial [J].World J Surg,2018,42(10):3302-3311.
[9] 戴朝六,徐锋,金添强.腹腔镜解剖性肝切除的利与弊[J/CD].中华普外科手术学杂志(电子版),2018,12(5):364-367.
[10] Moris D,Tsilimigras DI,Kostakis ID,et al.Anatomic versus non-anatomic resection for hepatocellular carcinoma:A systematic review and meta-analysis [J].Eur J Surg Oncol,2018,44(7):927-938.
[11] Otsuka Y,Katagiri T,Ishii J,et al.Gas embolism in laparoscopic hepatectomy:what is the optimal pneumoperitoneal pressure for laparoscopic major hepatectomy?[J].J Hepatobiliary Pancreat Sci,2013,20(2):137-140.
[12] Ueno M,Hayami S,Sonomura T,et al.Indocyanine green fluorescence imaging techniques and interventional radiology during laparoscopic anatomical liver resection (with video) [J].Surg Endosc,2018,32(2):1051-1055.
[13] 王宏光,许寅喆,陈明易,等.吲哚菁绿荧光融合影像引导在腹腔镜解剖性肝切除术中的应用价值 [J].中华消化外科杂志,2017,16(4):405-409.
[14] Yamamoto Y,Ikoma H,Morimura R,et al.Clinical analysis of anatomical resection for the treatment of hepatocellular carcinoma based on the stratification of liver function [J].World J Surg,2014,38(5):1154-1163.
[15] Kang KJ,Ahn KS.Anatomical resection of hepatocellular carcinoma:A critical review of the procedure and its benefits on survival [J].World J Gastroenterol,2017,23(7):1139-1146.
[16] Huang X,Lu S.A Meta-analysis comparing the effect of anatomical resection vs.non-anatomical resection on the long-term outcomes for patients undergoing hepatic resection for hepatocellular carcinoma [J].HPB (Oxford),2017,19(10):843-849.
[17] Kaibori M,Kon M,Kitawaki T,et al.Comparison of anatomic and non-anatomic hepatic resection for hepatocellular carcinoma [J].J Hepatobiliary Pancreat Sci,2017,24(11):616-626.
[18] 翟志超,任为正,刘志伟,等.解剖性与非解剖性肝切除治疗原发性肝癌远期疗效的比较[J].中华肝胆外科杂志,2017,23(11):771-775.
[19] 张雅敏,王建.解剖性肝切除与非解剖性肝切除对肝癌预后影响的研究进展 [J].中华外科杂志,2016,54(12):947-950.