精准肝脏外科

医学的进步和日益增长的医疗保健需求激发了外科范式的转变.笔者系统地回顾了外科学发展的历史趋势和现状,首次提出了基于确定性的外科实践新范式——精准外科.精准外科的主要特征可概括为确定性、预见性、可控性、集成化、规范化和个体化.精准的理念应用于肝脏外科领域,以寻求病灶清除、肝脏保护和损伤控制这3个外科要素的最佳平衡为策略,实现外科治疗中高效、安全和微创的多目标优化和患者的最佳康复.相信精准外科必将更广泛地应用在肝脏外科和其他外科领域,走向完美外科的最终目标.

Precision liver surgery

Continuous theoretical and technological progress in the face of increasing expectations for quality of health care and progress in medical technology has transformed the surgical paradigm. Based on the historical trends and technique advances, a novel paradigm of ＂Precision Surgery＂ has been proposed, which is featuring certainty-based practice to ensure the best results for each patient with multi-objective optimization of therapeutic effectiveness, surgical safety and minimal invasiveness. The main characteristics of precision surgery may be summarized as determinacy, predictability, controllability, integration, standardization and individualization. The strategy of precision hepatic surgery is to seek a balance of maximizing the removal of the target lesions, while maximizing the functional remnant liver and minimizing surgical invasiveness. The concept of precision surgery should be considered for wider application in liver surgery and other fields as a step toward the ultimate goal of perfect surgery.