中文摘要：

目的：探讨经前入路肝尾状叶全切除术治疗累及腔静脉旁部肝肿瘤的临床疗效。方法：采用回顾性横断面研究方法。收集2004年8月至2014年5月第二军医大学东方肝胆外科医院收治的72例累及肝尾状叶腔静脉旁部肿瘤患者的临床资料。72例患者中，肝恶性肿瘤49例，肝良性肿瘤23例；43例肿瘤超出肝尾状叶范围，29例肿瘤局限于肝尾状叶。根据肿瘤累及范围选择行经前入路单纯肝尾状叶全切除术或肝中叶联合肝尾状叶全切除术。观察指标：（1）手术情况：手术方式、肝血流阻断方式、第一肝门阻断时间、手术时间、术中出血量、术中输血例数。（2）术后恢复情况：术后住院时间、术后并发症发生情况。（3）术后病理学检查情况：肝恶性肿瘤患者手术切缘。（4）随访情况。采用门诊和电话方式进行随访，了解患者术后生存情况。随访时间截至2016年8月。偏态分布的计量资料以M（范围）表示。采用 KaplanMeier法计算生存率。结果：（1）手术情况：72例患者均成功完成经前入路肝尾状叶全切除术，无围术期死亡患者。72例患者中，17例行单纯肝尾状叶全切除术，其中2例行第一肝门阻断、13例行第一肝门联合选择性肝静脉阻断、2例行全肝血流阻断；42例行肝Ⅳ段联合肝尾状叶全切除术，其中12例行第一肝门阻断、27例行第一肝门联合选择性肝静脉阻断、3例行全肝血流阻断；13例行肝Ⅳ、Ⅴ、Ⅷ段联合肝尾状叶全切除术，其中2例行第一肝门阻断、11例行第一肝门联合选择性肝静脉阻断。72例患者手术时间、第一肝门阻断时间、术中出血量、术中输血例数分别为205 min（120～445 min）、49 min（24～139 min）、 800 mL（200～5 000 mL）、41例；其中17例行单纯肝尾状叶全切除术患者上述指标分别为245 min（140～345 min）、52 min（29～75 min）、700 mL（200～3 000 mL）、10

英文摘要：

Objective：To explore the clinical efficacy of total caudate lobectomy via anterior hepatic transaction in treatment of hepatic tumor involving paracaval portion of caudate lobe. Methods：The retrospective crosssectional study was conducted. The clinical data of 72 patients with hepatic tumor involving paracaval portion of caudate lobe who were admitted to the Eastern Hepatobiliary Hospital of Second Military Medical University from August 2004 to May 2014 were collected. Of 72 patients, 49 had malignant hepatic tumors and 23 had benign hepatic tumors. Tumors of 43 patients exceeded caudate lobe of the liver and tumors of 29 patients didn′t exceed caudate lobe of the liver. According to hepatic tumor involving range, total caudate lobectomy via anterior hepatic transaction or mesohepatectomy with total caudate lobectomy were selected. Observation indicators： （1） operation situations： surgical procedures, hepatic vascular occlusion, time of the first hepatic hilum occlusion, operation time, volume of intraoperative blood loss, number of patient with blood transfusion; （2） postoperative recovery situations： duration of hospital stay, postoperative complications; （3） postoperative pathological examinations： surgical margin of malignant hepatic tumor; （4） followup. Followup using outpatient examination and telephone interview was performed to detect postoperative survival of patients up to August 2016. Measurement data with skewed distribution were described as M （range）. Survival rate was calculated by the KaplanMeier method. Results： （1） Operation situations： all 72 patients received successful total caudate lobectomy via anterior hepatic transaction, without perioperative death. Of 17 patients undergoing single total caudate lobectomy, 2 underwent the first hepatic hilum occlusion, 13 underwent the first hepatic hilum occlusion combined with hepatic veins occlusion and 2 underwent total hepatic vascular occlusion. Of 42 patients undergoing hepatic segment Ⅳresection combin