title: [Progress of clinical application of anatomic resection and nonanatomic resection].
abstract: Currently surgical resection is still the best therapeutic method to treat hepatocellular carcinoma, but the effects of different surgical methods on postoperative recurrence of hepatocellular carcinoma are still controversial. According to the technical points and developmental course of anatomical and non-anatomical hepatectomy, this paper analyzes the published literature and draws a conclusion that success of hepatectomy depends on exact balance between residual liver reserve function and radical resection of tumor. The risk of microvascular invasion is low for solitary tumor with a maximum diameter of less than 2 cm, the results of anatomic and nonanatomic hepatic resection are comparable. When the tumor's diameter of 2 to 5 cm in size, the risk of microvascular invasion increase, if the patients with good preserved liver function, the anatomical resection is superior to nonanatomic resection for better local control and inhibiting intrahepatic metastasis. In the full assurance of the margin cases, anatomical hepatectomy should be used. On the other hand, non-anatomical hepatectomy surgery has a lower stress risk and can maintaina better liver function reserve, which can be applied to the patients with impaired liver function. For patients with a tumor diameter more than 5 cm, multinodular tumor, microvascular invasion and severe liver cirrhosis, the focus is on the prevention of postoperative liver failure, so non-anatomic hepatectomy can be considered.
authors.affiliation: Department of Hepatobiliary Surgery, Tianjin First Center Hospital, Tianjin 300192, China.
authors.forename: Y M
authors.initials: YM
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: Wang
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011184:Postoperative Period