title: Advantages of thoracoabdominal approach by oblique incision for right-side hepatectomy.
abstract: OBJECTIVE
  Thoracoabdominal approach might be safe and facilitate hepatic resection for tumors located in the right lobe. To evaluate the clinical usefulness of the thoracoabdominal approach using oblique incision for the right-side hepatectomy, we compared the perioperative data with those of the abdominal approach.
  
  
  METHODS
  The oblique incision for the thoracoabdominal approach was placed along the intercostal space (Oblique group, n=13). The J-shape incision for abdominal approach consisted of an upper median incision and transverse incision (J-shape group, n=13).
  
  
  RESULTS
  Patient demographics were similar in the two groups. Operation time was significantly shorter in the oblique group (292 +/- 122 min) than in the J-shape group (450 +/- 137 min, p < 0.01). The difference was noted regardless of the extent of hepatic resection. Clamping time and blood loss were similar in the two groups. The postoperative period of use of analgesia tended to be shorter in the oblique group (9 +/- 3 days) than in the J-shape group (15 +/- 11 days) but not significant (p = 0.08). Postoperative liver function tests, complications and clinical outcome were not significantly different between the two groups.
  
  
  CONCLUSIONS
  Thoracoabdominal approach using oblique incision was useful for resection of liver tumors located in the hepatic dome and posterior segment.
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Sumida
authors.forename: Syuichi
authors.initials: S
authors.lastname: Tobinaga
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Shindo
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shibasaki
authors.forename: Noboru
authors.initials: N
authors.lastname: Ide
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tokunaga
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tagawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nakamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies