摘要目的:探讨腹腔镜下定构流程化解剖性肝中叶切除治疗肝细胞癌的可行性和有效性。方法:回顾性分析2017年4月至2021年4月中山大学孙逸仙纪念医院肝胆外科连续行腹腔镜下定构流程化解剖性肝中叶切除治疗的65例肝细胞癌患者的病例资料。男性39例，女性26例，年龄［ M（ Q R）］61.2（29.5）岁（范围：25~80岁）；体重指数（24.2±3.8）kg/m 2（范围：19.5~26.1 kg/m 2）。腹部CT检查结果显示，肿瘤最大径为（6.7±2.9）cm（范围：3.4~10.5 cm）。以显露矢状部、肝中静脉、肝右静脉等标志性脉管为目标实施定构流程化切除，并对围手术期结果和近期肿瘤学疗效进行分析。 结果:65例患者均行腹腔镜下定构流程化解剖性肝中叶切除。手术时间为（190.5±70.4）min（范围：90~280 min），出血量为（370.6±120.8）ml（范围：100~1 050 ml）。65例患者术中均未输血，无中转开腹。术后出现并发症8例（12.3%）。术后住院时间为（7.5±2.5）d（范围：5~18 d）；无住院期间死亡病例及30 d内再住院病例。术后病理学检查结果显示均为R0切缘，最小切缘为（2.4±1.9）cm（范围：0.5~3.1 cm）。术后随访结果显示，1年内肿瘤复发率为12.3%（8/65）。结论:腹腔镜下定构流程化解剖性肝中叶切除可用于治疗肝细胞癌患者，可获得较好的临床效果。

abstractsObjective:To investigate the feasibility and oncological efficacy of structuring process approach to laparoscopic anatomical liver central lobectomy for hepatocellular carcinoma.Methods:The clinical data of 65 patients with hepatocellular carcinoma who underwent laparoscopic anatomical liver central lobectomy at the Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital from April 2017 to April 2021 was retrospectively analyzed. There were 39 males and 26 females,aged ( M( Q R)) 61.2 (29.5) years (range:25 to 80 years).The body mass index was (24.2±3.8) kg/m 2 (range:19.5 to 26.1 kg/m 2) and the tumor diameter was (6.7±2.9)cm(range:3.4 to 10.5 cm).This structuring process approach was designed using a series of main vessels as the plane markers, along which liver transection was carried out. The perioperative indicators and early oncological efficacy were then analyzed. Results:All the procedures were successfully carried out laparoscopically. The operative time was (190.5±70.4) minutes (range:90 to 280 minutes). The blood loss was (370.6±120.8)ml(range:100 to 1 050 ml). No patient received blood transfusion or converted to laparotomy. Postoperative complications occurred in 8 cases(12.3%). Postoperative hospital stay was (7.5±2.5) days(range:5 to 18 days).There was no perioperative death and rehospitalization within 30 days. Pathological study showed all the operations to be R0 resections, the average surgical margin was (2.4±1.9)cm(range:0.5 to 3.1 cm).The tumor recurrence rate was 12.3% after 1 year follow-up.Conclusion:Structuring process approach to laparoscopic anatomical liver central lobectomy could be used to treat patients with hepatocellular carcinoma.