肝肿瘤患者的分期手术治疗及残肝代偿性肥厚的最佳方法:文献综述

V. A. Pelts, V. E. Tropin, V. V. Pavlenko, A. O. Krasnov
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引用次数: 0

摘要

在医学发展的现阶段,肝脏外科的发展要求专科医生在肝肿瘤切除术的手术治疗中,制定以患者为导向的合理手术策略,并采用现代方法对术后肝功能衰竭进行诊断和预测,从而形成降低广泛切除后肝残余不足导致严重术后并发症风险的方法。本文综述了肝脏肿瘤的诊断和治疗中存在的问题,并就及时预防肝切除后功能衰竭的相关性提出了目前的观点。本研究考虑了在计划和实施广泛肝切除术时评估并发症和不良后果风险的方法,定义了切除术后肝衰竭的概念,并强调了代偿性肥厚的主要机制。本文探讨了广泛肝切除后残余实质浸润性肥大最常用的治疗方法及其优缺点。分析了两阶段肝切除策略失败的主要可能原因。对现有当代文献的批判性分析使该论文的作者能够确定进一步改善广泛肝脏切除术结果的可能方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Staged Surgical Treatment for Patients with Liver Tumors and Optimal Method of Vicarious Hypertrophy of the Liver Remnant: Literature Review
The evolution of hepatic surgery at the present stage of medical development requires specialists to develop patient-oriented rational surgical tactics and use modern methods for the diagnosis and prediction of post-resection liver failure in the surgical treatment of liver tumors by resection, thereby forming approaches that reduce the risks of severe postoperative complications associated with insufficient liver remnants remaining after extensive resection. The paper reviews the problematic issues of diagnosis and treatment of liver tumors, as well as provides current views on the relevance of timely prevention of post-resection liver failure. The study considers methods for assessing the risks of complications and adverse outcome when planning and performing extensive liver resections, defines the concept of post-resection liver failure, and highlights the main mechanisms of vicarious hypertrophy. The paper examines the most commonly used methods for vicarious hypertrophy of the parenchyma remaining after extensive liver resection, their advantages, and disadvantages. The main possible causes of failures in developing a strategy for two-stage liver resections are analyzed. A critical analysis of available contemporary literature enabled the authors of the paper to identify possible ways to further improve the results of extensive liver resections.
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