Anatomical subsegmentectomy in the lateral segment for hepatocellular carcinoma.
Anatomical subsegmentectomy in the lateral segment for hepatocellular carcinoma.
复制标题
肝细胞癌侧段解剖亚段切除术。
作者：
H. Sadamori;H. Matsuda;S. Shinoura;Y. Umeda;R. Yoshida;D. Sato;Hisashi Utsumi;T. Ohnishi;T. Yagi
在这篇文章中，我们描述了一种安全的技术和2节段和3节段解剖切除慢性肝病患者的结果。第2节段亚节段切除术时，在脐部一侧横切阿兰管，然后横切喂食第2节段的滑糖蒂根正上方的肝实质。即使在肝硬化患者中，该手术也可以安全地环绕和解剖格利松蒂供食节2的根部。在肝表面标记出变色区域后，行第2段和第3段之间的实质横切。在3节段亚节段切除术的病例中，在肝实质切除术前，将喂养3节段的滑糖蒂的根从脐部腹侧环绕并切除。使用我们的技术，我们对4例肝细胞癌患者进行了3节段的亚节段切除术，对2例肝细胞癌患者进行了2节段的亚节段切除术。6例患者均无术后肝功能衰竭，残肝功能正常。虽然6例患者中有3例在肝切除术后出现HCC复发，但这3例患者均可对HCC复发进行多种、多种治疗。对于位于侧段的肝细胞癌进行亚节段切除术是安全的，并有助于保留剩余的肝功能。
In this article, we describe a safe technique and the outcome of anatomical subsegmentectomies of segments 2 and 3 in patients with chronic liver disease. In cases of subsegmentectomy of segment 2, Arantius duct is transected at the side of umbilical portion and then the liver parenchyma located just above the root of the glissonean pedicle feeding segment 2 is transected. This procedure allows to encircle and dissect the root of the glissonean pedicle feeding segment 2 safely even in cirrhotic patients. After marking the discolored area on the liver surface, parenchymal transection between segment 2 and segment 3 was performed. In cases of subsegmentectomy of segment 3, the root of the glissonean pedicle feeding subsegment 3 is encircled and dissected from the ventral side of the umbilical portion before liver parenchymal resection. Using our technique, we performed subsegmentectomies of segment 3 in four hepatocellular carcinoma (HCC) patients and of segment 2 in two HCC patients. There was no postoperative liver failure and remnant liver function was adequate in all six of our cases. Although three of the six patients had HCC recurrence after hepatectomy, various and multiple treatments for HCC recurrence could be performed in these three patients. Subsegmentectomies for HCC located in the lateral segment were performed safely and could contribute to preservation of remnant liver function.