title: A prospective evaluation of laparoscopic versus open left lateral hepatic sectionectomy.
abstract: BACKGROUND
  Left lateral sectionectomy is one of the most commonly performed laparoscopic liver resections, but limited clinical data are actually available to support the advantage of laparoscopic versus open-liver surgery. The present study compared the short-term outcomes of laparoscopic versus open surgery in a case-matched analysis.
  
  
  METHODS
  Surgical outcome of 20 patients who underwent left lateral sectionectomy by laparoscopic approach (LHR group) from September 2005 to January 2007 were compared in a case-control analysis with those of 20 patients who underwent open left lateral sectionectomy (OHR group). Both groups were similar for: tumor size, preoperative laboratory data, presence of cirrhosis, and histology of the lesion. Surgical procedures were performed in both groups combining the ultrasonic dissector and the ultrasonic coagulating cutter without portal clamping.
  
  
  RESULTS
  Compared with OHR, the LHR group had a decreased blood loss (165 mL versus 214 mL, P=0.001), and earlier postoperative recovery (4.5 versus 5.8 days, P=0.003). There were no significant differences in terms of surgical margin and operative time. Morbidity was comparable between the two groups, but two cases of postoperative ascites were recorded in two cirrhotic patients in the OHR. Major complications were not observed in either groups.
  
  
  CONCLUSIONS
  Laparoscopic resection results in reduced operative blood loss and earlier recovery with oncologic clearance and operative time comparable with open surgery. Laparoscopic liver surgery may be considered the approach of choice for tumors located in the left hepatic lobe.
authors: Department of Surgery-Liver Unit, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Via Olgettina, 60-20132, Milan, Italy. aldrighetti.luca@hsr.it
authors: Luca
authors: L
authors: Aldrighetti
authors: Carlo
authors: C
authors: Pulitanò
authors: Marco
authors: M
authors: Catena
authors: Marcella
authors: M
authors: Arru
authors: Eleonora
authors: E
authors: Guzzetti
authors: Massimiliano
authors: M
authors: Casati
authors: Laura
authors: L
authors: Comotti
authors: Gianfranco
authors: G
authors: Ferla
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D016022:Case-Control Studies; D004564:Electrocoagulation; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
references: Am J Surg. 2005 Feb;189(2):190-4
references: 15720988
references: Ann Surg. 2006 Nov;244(5):815-20
references: 17060776
references: Surgery. 2004 Oct;136(4):804-11
references: 15467665
references: Br J Surg. 2007 Jan;94(1):58-63
references: 17054316
references: Ann Surg. 2002 Jul;236(1):90-7
references: 12131090
references: J Gastrointest Surg. 2006 Jul-Aug;10(7):974-9
references: 16843867
references: Surg Endosc. 2003 Dec;17(12):1914-8
references: 14574547
references: Hepatogastroenterology. 1998 Nov-Dec;45(24):2333-8
references: 9951918
references: Arch Surg. 2003 Jul;138(7):763-9; discussion 769
references: 12860758
references: J Hepatobiliary Pancreat Surg. 2002;9(2):242-8
references: 12140614
references: Br J Surg. 2006 Jan;93(1):67-72
references: 16273531
references: Ann Surg. 2004 Aug;240(2):205-13
references: 15273542
references: Surg Endosc. 2002 Jul;16(7):1059-63
references: 12165823
references: Surgery. 1996 Sep;120(3):468-75
references: 8784399
references: J Am Coll Surg. 2003 Feb;196(2):236-42
references: 12595052
references: Am Surg. 2007 Mar;73(3):256-60
references: 17375782