中国实用外科杂志2026，Vol.46Issue(3)：294-298,310,6.DOI:10.19538/j.cjps.issn1005-2208.2026.03.03
"数智化"及微创外科时代肝血管瘤规范化治疗
Standardized treatment of hepatic hemangioma in the era of digital intelligence and minimally invasive surgery
摘要
Abstract
As a common benign liver tumor,the diagnostic and therapeutic paradigm for hepatic hemangioma has shifted from experience-based judgment centered primarily on tumor size to a comprehensive assessment based on symptoms,growth rate,risk of complications,diagnostic certainty,and general condition.Multidisciplinary team(MDT)collaboration has become an important prerequisite for standardized decision-making.The therapeutic goal is to ensure efficacy while maximizing preservation of normal liver parenchyma and minimizing overtreatment.Surgery remains an important treatment modality.Enucleation is preferred because it is more consistent with the anatomical characteristics of benign lesions,whereas hepatectomy is more suitable for deeply located lesions,extensive lesions,or lesions in which preservation of the surrounding liver tissue is difficult.Perioperative management focuses on the control of bleeding risk and relies on vascular inflow occlusion,liver hanging maneuver,low central venous pressure,and the application of refined surgical devices.With the continuous development of minimally invasive surgery,laparoscopic and robotic techniques have shown advantages in the management of complex lesions,including reduced surgical trauma,faster postoperative recovery,and improved procedural precision.Three-dimensional reconstruction based on computed tomography(CT)and magnetic resonance imaging(MRI),indocyanine green(ICG)fluorescence navigation,augmented reality(AR),and artificial intelligence-assisted decision-making are driving the transition from experience-based surgery to precision surgery.In the field of interventional therapy,transcatheter arterial chemoembolization(TACE)has become an important minimally invasive option,showing favorable efficacy in reducing lesion size and relieving symptoms,and it can also serve as a bridging treatment before surgery for giant hemangiomas;however,its long-term efficacy and indications still require individualized evaluation.Ablative therapy mainly includes radiofrequency ablation(RFA)and microwave ablation(MWA),both of which are minimally invasive and efficient.Among them,MWA may offer advantages in shortening procedure time,reducing the heat-sink effect,and lowering the risk of hemolysis-related complications.In the future,diagnosis and treatment are expected to advance toward the integration of digital intelligence,optimization of combined treatment strategies,promotion of standardized systems,and individualized precision intervention,thereby achieving better clinical outcomes with less trauma.关键词
肝血管瘤/肝切除术/血管瘤剥除术/经导管动脉化疗栓塞/热消融/微创外科/机器人手术/人工智能辅助决策Key words
hepatic hemangioma/hepatectomy/hemangioma enucleation/transcatheter arterial chemoembolization/thermal ablation/minimally invasive surgery/robotic surgery/artificial intelligence-assisted decision-making分类
医药卫生引用本文复制引用
张伟,陈孝平.."数智化"及微创外科时代肝血管瘤规范化治疗[J].中国实用外科杂志,2026,46(3):294-298,310,6.基金项目
国家自然科学基金面上项目(No.82373052) （No.82373052）
武汉市重点研发计划项目(No.2022023502015182) National Natural Science Foundation of China General Funding Program(No.82373052) （No.2022023502015182）
Wuhan Key Research and Development Program(No.2022023502015182) （No.2022023502015182）
