左侧肝实质优先入路在腹腔镜解剖性肝中区肿瘤切除术中的应用
Application of the left side hepatic parenchymal transection‑first approach in laparoscopic central tumor anatomical hepatectomy
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摘要: 腹腔镜解剖性肝中区肿瘤切除术难度大、风险高,存在诸多技术要点,其核心技术环节之一为腹腔镜下手术入路的选择。笔者根据肝中区的解剖特点,采用“Easy first”策略,总结出左侧肝实质优先入路,并应用于腹腔镜解剖性肝中区肿瘤切除术,该技术可降低目标Glisson蒂的处理难度和手术风险,简便快速、安全有效,更加符合肿瘤的“无瘤原则”,在腹腔镜解剖性肝中区肿瘤切除术中具有临床应用价值。Abstract: Acting as a difficult and high risk procedure in the operation, laparoscopic central tumor anatomical hepatectomy possesses various technical points that shall be noted in the process of application. The choice of laparoscopic approach has been recognized to be one of the key technical links for this technique. According to the anatomical characteristics of the middle lobe of liver and "Easy first" strategy, the authors summarize the laparoscopic central tumor anatomical hepatectomy technology with left side hepatic parenchymal transection‑first approach. The left side hepatic parenchymal transection‑first approach is found to be simple, fast, safe and effective in operation, which overcomes the challenges of complicated target Glisson pedicle operation and high technical risk of laparoscopic anatomical hepatectomy. The approach also better complies with the "no‑touch" principle for malignant tumors. Significantly, it exhibits clinical application value in laparoscopic central tumor anatomical hepatectomy.