title: Ten-year experience of totally laparoscopic liver resection in a single institution.
abstract: BACKGROUND
  Recent developments in liver surgery include the introduction of laparoscopic liver resection. The aim of the present study was to review a single institution's 10-year experience of totally laparoscopic liver resection (TLLR).
  
  
  METHODS
  Between May 1997 and April 2008, 82 patients underwent TLLR for hepatocellular carcinoma (HCC) (37 patients), liver metastases (39) and benign liver lesions (six). Operations included 69 laparoscopic wedge resections, 11 laparoscopic left lateral sectionectomies and two thoracoscopic wedge resections. Nine patients underwent simultaneous laparoscopic resection of colorectal primary cancer and synchronous liver metastases.
  
  
  RESULTS
  Median operating time was 177 (range 70-430) min and blood loss 64 (range 1-917) ml. Median tumour size and surgical margin were 25 (range 15-85) and 6 (range 0-40) mm respectively. One procedure was converted to a laparoscopically assisted hepatectomy. Three patients developed complications. Median postoperative stay was 9 (range 3-37) days. The overall 5-year survival rate after surgery for HCC and colorectal metastases was 53 and 64 per cent respectively.
  
  
  CONCLUSIONS
  TLLR can be performed safely for a variety of primary and secondary liver tumours, and seems to offer at least short-term benefits in selected patients.
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, Uchimaru Morioka, Iwate, Japan. sakira@iwate-med.ac.jp
authors.forename: A
authors.initials: A
authors.lastname: Sasaki
authors.forename: H
authors.initials: H
authors.lastname: Nitta
authors.forename: K
authors.initials: K
authors.lastname: Otsuka
authors.forename: T
authors.initials: T
authors.lastname: Takahara
authors.forename: S
authors.initials: S
authors.lastname: Nishizuka
authors.forename: G
authors.initials: G
authors.lastname: Wakabayashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D010535:Laparoscopy; D007902:Length of Stay; D008107:Liver Diseases / Q000601:surgery; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications / Q000209:etiology; D016019:Survival Analysis