Minimally invasive liver surgery (MILS) has been slowly introduced in the past two decades and today represents a major weapon in the fight against HCC, for several reasons. This narrative review conveys the major emerging concepts in the field. The rise in metabolic-associated steatotic liver disease (MASLD)-related HCC means that patients with significant cardiovascular risk will benefit more profoundly from MILS. The advent of efficacious therapy is leading to conversion from non-resectable to resectable cases, and therefore more patients will be able to undergo MILS. In fact, resection outcomes with MILS are superior compared to open surgery both in the short and long term. Furthermore, indications to surgery may be further expanded by its use in Child B7 patients and by the use of laparoscopic ablation, a curative technique, instead of trans-arterial approaches in cases not amenable to radiofrequency. Therefore, in a promising new approach, multi-parametric treatment hierarchy, MILS is hierarchically superior to open surgery and comes second only to liver transplantation.
微创肝脏手术（MILS）在过去二十年中逐步引入，如今已成为对抗肝细胞癌（HCC）的重要武器，其背后有多重原因。本叙述性综述阐述了该领域的主要新兴理念。代谢相关脂肪性肝病（MASLD）相关HCC的发病率上升，意味着具有显著心血管风险的患者将从MILS中获益更深。有效治疗手段的出现使得部分不可切除病例转化为可切除病例，因此更多患者将有机会接受MILS。事实上，无论是短期还是长期效果，MILS的切除结果均优于开腹手术。此外，通过应用于Child B7级患者，以及在不适合射频消融的病例中使用腹腔镜消融（一种根治性技术）替代经动脉介入治疗，手术适应症可能进一步扩大。因此，在多参数治疗层级这一前景广阔的新策略中，MILS在层级上优于开腹手术，仅次于肝移植。
肿瘤(癌症)患者之家