Dong Kuiran.Recent advances of minimally invasive liver surgery in children[J].Journal of Clinical Pediatric Surgery,2025,(11):1006-1010.[doi:10.3760/cma.j.cn101785-202508008-002]
儿童肝脏外科微创手术新进展
- Title:
- Recent advances of minimally invasive liver surgery in children
- Keywords:
- Liver; Minimally Invasive Surgical Procedures; Child
- 摘要:
- 近年来,儿童肝脏外科微创手术技术迅速发展,腹腔镜肝脏切除术(laparoscopic liver resection,LLR)与机器人辅助肝切除术(robotic liver resection,RLR)已成为主流。与传统开放手术相比,微创手术能显著减少术中出血量、缩短住院时间、降低并发症发生率,尤其适用于儿童患者。机器人手术在视野、器械灵活性和操作稳定性方面优于腹腔镜,特别适用于复杂肝段切除。吲哚菁绿(indocyanine green,ICG)荧光成像、肝脏悬吊技术(liver-hanging maneuver,LHM)、门静脉栓塞术(portal vein embolization,PVE)及三维可视化技术等辅助手段进一步提高了手术安全性与精准性。尽管技术不断进步,儿童肝脏微创手术仍面临长期肿瘤学结局数据不足、技术标准化困难及成本效益等挑战。未来需加强培训体系建设、推动技术普及,并探索人工智能与个体化治疗的整合应用。
- Abstract:
- Recent years have seen rapid advancements in minimally invasive liver surgery (MIS) for children.And laparoscopic liver resection (LLR) and robotic liver resection (RLR) are becoming mainstream.As compared to open surgery,MIS may significantly reduce volume of intraoperative blood loss,shorten hospitalization stay and lower complication rates,making it ideal for children.RLR offers superior visual clarity,instrument flexibility and operational stability over LLR,especially during complex hepatic segment resections.Auxiliary techniques of indocyanine green (ICG) fluorescent imaging,liver hanging maneuver (LHM),portal vein embolization (PVE) and three dimensional (3D) visualization have further enhanced surgical safety and precision.Despite these advances,various challenges remain,including limited long-term oncological outcome data,difficulties of standardizing techniques and cost-effectiveness concerns.Future efforts should focus upon structured training systems,broader adoption of these technologies and a sound integration of artificial intelligence and personalized therapies.
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备注/Memo
收稿日期:2025-8-4。
基金项目:唐仲英基金会(ZSBK0070)
通讯作者:董岿然，Email:kuirand@fudan.edu.cn