title: Laparoscopic liver surgery for patients with hepatocellular carcinoma.
abstract: BACKGROUND
  Laparoscopic hepatectomy is feasible for hepatocellular carcinoma (HCC) today. This is a retrospective study of the patients with HCC treated by liver resection with a totally laparoscopic approach.
  
  
  METHODS
  This study recruited 116 patients (92 male, 24 female) that underwent laparoscopic liver resection (LR) for HCC. Patients were divided into two groups: group I: (n = 97, 78 male,19 female) those with a volume of resection less than two segments; group II: (n = 19, 14 male, 5 female) those with a volume of resection of more than two segments. The distribution of the tumor-node-metastasis (TNM) stage of patients in the two groups was not significantly different.
  
  
  RESULTS
  Patients resumed full diet on the second or third day after the operation, and the average length of hospital stay was 6 days. The operation time was 152.4 +/- 336.3 min and 175.8 +/- 57.4 min, while blood loss was 101.6 +/- 324.4 mL and 329.2 +/- 338.0 ml, for groups I and II, respectively. Five patients (5.2%) in group I and three patients (15.8%) in group II required blood transfusion (p = 0.122). The mortality rate was zero among our patients and complication rates were 6.2% and 5.2% for groups I and II, respectively. The 1-year, 3-year, and 5-year survival rates were 85.4%, 66.4%, and 59.4% for group I, and 94.7%, 74.2%, and 61.7% for group II, respectively, with no significant difference between two groups (p = 0.1237).
  
  
  CONCLUSIONS
  Laparoscopic liver resection is a procedure of significant risk and is more technically demanding in comparison with traditional open method. There was no significant difference in survival rates, based on the volume of resection. Laparoscopic surgery should be performed in selected patients as the postoperative quality of life of patients is better than that with open resection.
authors.affiliation: Department of Surgery, Gastrointestinal Center, Yuan General Hospital, Kaohsiung, Taiwan. chy_med@yuanhosp.com.tw
authors.forename: Hong-Yaw
authors.initials: HY
authors.lastname: Chen
authors.forename: Chung-Chou
authors.initials: CC
authors.lastname: Juan
authors.forename: Chen-Guo
authors.initials: CG
authors.lastname: Ker
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies