门静脉流域解剖性肝切除治疗肝细胞癌的理论与技术实践
Theory and technical practice of anatomic liver resection based on portal territory for the treatment of hepatocellular carcinoma
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摘要: 解剖性肝切除旨在对荷瘤门静脉流域进行系统性切除,以提高肝细胞癌手术疗效,但由于传统理论和临床实践存在偏差,其肿瘤学疗效尚存争议。门静脉流域解剖性肝切除(PT‑AR)基于真实门静脉流域分析进行手术规划,以荧光染色引导荷瘤门静脉流域切除同时,显露代表性流域间静脉,实现完整切除荷瘤门静脉流域同时可保证剩余肝脏完整功能。PT‑AR基于经典解剖性肝切除核心理论,从技术层面修正经典解剖性肝切除理论与临床实践之间的偏差,有望更好实现肝细胞癌肿瘤学疗效。Abstract: Anatomic resection aims to improve the surgical efficacy of hepatocellular carcinoma by systematic resection of portal territory. However, due to its deviation of traditional theory and practice, the oncology effect is questionable. Anatomic resection based on portal territory(PT‑AR) is planned by the analysis of real portal vein territory, and performed complete resection of tumor‑bearing portal territory by fluorescent guidance, while exposing typical inter‑territory hepatic vein, so as to ensure the complete function of future liver remnant. PT‑AR is based on the core theory of classical anatomic resection, which will correct the deviation of traditional theory and practice from the technical level, so as to lead a better surgical oncology outcomes for hepatocellular carcinoma.