title: Thoracoabdominal approaches versus inverted T incision for posterior segmentectomy in hepatocellular carcinoma.
abstract: OBJECTIVE
  The purpose of the present study was to clarify the indications for a thoracoabdominal right oblique approach and an inverted L incision in posterior segmentectomy of the liver for hepatocellular carcinoma.
  
  
  METHODS
  Forty-six patients with hepatocellular carcinoma who underwent posterior segmentectomy with thoracotomy were divided into 2 groups according to the incision: thoracoabdominal right oblique incision (group A, n = 17) and inverted L incision (group B, n = 29). The perioperative factors of the patients in the 2 groups were compared retrospectively.
  
  
  RESULTS
  No significant differences were found in the preoperative factors between the groups. However, a longer operation time (P = 0.01) and more blood loss (P = 0.02) were noted in group B. Although there was no significant difference between the groups in the overall morbidity rate (P = 0.36), a higher rate of pleural effusion was recognized in group A (P = 0.01).
  
  
  CONCLUSIONS
  Thoracoabdominal right oblique incision may be suitable for use as an approach for posterior segmentectomy when manipulation of the left lobe is not required.
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery of National Cancer Center Hospital, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sato
authors.forename: Y
authors.initials: Y
authors.lastname: Sugawara
authors.forename: S
authors.initials: S
authors.lastname: Yamasaki
authors.forename: K
authors.initials: K
authors.lastname: Shimada
authors.forename: T
authors.initials: T
authors.lastname: Takayama
authors.forename: M
authors.initials: M
authors.lastname: Makuuchi
authors.forename: T
authors.initials: T
authors.lastname: Kosuge
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000503:physiopathology; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies