In recent years, liver resection has achieved good effect, various types of liver resection 5-year survival has reached 20% -30%, with small HCC (diameter <5 cm) 5-year survival after resection of up to around 60%.
1. Resection of the evolution of the concept of the type of liver resection can be divided into the current rules of irregular hepatectomy and liver resection. Anatomic site of tumor where the past will be close to the first, second, third portal as central liver tumors, even smaller tumor size, excision is very difficult, but recent improvements in the retractor, intraoperative bleeding improvements in technology, technology, skilled hepatectomy, the liver can be removed any part of which proposed a "non-restricted liver surgery," the new concept. Therefore, whether the removal of liver cancer should be considered the lesion size, number, location and vascular infiltration, while patients with systemic conditions and residual liver background be considered in the case of liver disease.
2. Hepatocellular carcinoma patients with indications for surgical removal of the physical condition to withstand surgery. The remaining liver after surgery to maintain the body needs a variety of metabolic functions.
3. The manner and selection of liver resection
(1) the treatment of small hepatocellular carcinoma: the majority of scholars, advocates of small hepatocellular carcinoma line sub-segment or partial liver resection that removed the tumor from the liver edge 2 cm can be achieved by radical purposes.
(2) the treatment of large hepatocellular carcinoma: current claims of large liver resection, whenever possible, all should be surgically removed. From a tumor biology point of view, a certain volume of the tumor is the burden of immune function, surgical resection can reduce this burden, thereby enhancing the ability of patients with cancer.
Liver resection, (3) A temporary unresectable HCC to be reduced after large liver resection: preoperative estimate of unresectable large liver, should interventional therapy. Intraoperative findings of unresectable large liver, it is desirable that the line intraoperative hepatic arterial embolization therapy or cryotherapy, two lines to be removed after tumor shrinkage.