title: Laparoscopic and thoracoscopic partial hepatectomy for hepatocellular carcinoma.
abstract: Several trials have been reported examining laparoscopic liver resections for the treatment of various kinds of liver tumors. However, there are no detailed reports on the use of laparoscopic (LH) and thoracoscopic (TH) hepatectomy for the treatment of hepatocellular carcinoma (HCC). Eleven laparoscopic and thoracoscopic partial liver resections were attempted for treating HCC. The indications for performing a laparoscopic or thoracoscopic partial hepatectomy were as follows: (1) the tumor was located on the surface of the liver; (2) the tumor was less than 3 cm in diameter; and (3) the tumor was not located adjacent to any large vessels. A TH was performed if the tumor was located in segment 8; an LH was performed if the tumor was located in segment 3, 4, or 5. Hand-assisted operations were performed in two patients. The mean operating time was 186.1 +/- 44.0 minutes (range 130-310 minutes). The operative blood loss was 218.3 +/- 197.6 ml (range 20-650 ml). The mean postoperative hospital stay was 11.3 +/- 5.7 days (range 7-26 days). Two patients experienced postoperative complications (wound infection and ascites). No local recurrences have occurred to date. The overall 5-year survival rate and disease-free 5-year survival rate were 75.0% and 38.2%, respectively. Laparoscopic and thoracoscopic hepatic resections are less invasive than conventional surgical techniques and are useful for treating HCC in select patients.
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-Ku, Tokyo 113-8519, Japan. teraken.srg1@tmd.ac.jp
authors.forename: Kenichi
authors.initials: K
authors.lastname: Teramoto
authors.forename: Tohru
authors.initials: T
authors.lastname: Kawamura
authors.forename: Susumu
authors.initials: S
authors.lastname: Takamatsu
authors.forename: Norio
authors.initials: N
authors.lastname: Noguchi
authors.forename: Noriaki
authors.initials: N
authors.lastname: Nakamura
authors.forename: Shigeki
authors.initials: S
authors.lastname: Arii
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D013906:Thoracoscopy; D016896:Treatment Outcome