title: Laparoscopic hepatectomy for liver tumors: proposals for standardization.
abstract: OBJECTIVE
  We draw on our experience with laparoscopic hepatectomy (LH) to present recommendations for standardization of LH for the treatment of liver tumors.
  
  
  METHODS
  At our center, 90 LHs were performed from April 1993 to January 2008. These were divided equally into early cases and late cases, and short-term postoperative results were compared. Forty-nine of the LH procedures were total-laparoscopic procedures, 16 were hand-assisted procedures, and 25 were laparoscopy-assisted procedures. The tumors were malignant in 76 cases and benign in 14 cases.
  
  
  RESULTS
  Among late cases, the numbers of malignant tumors and tumors located in the posterosuperior region of the liver (Segments VII, VIII, and IVb) were significantly higher than among early cases; however, operative blood loss and postoperative hospital stay were significantly lower in the late cases (158.9 +/- 213.4 vs. 377.6 +/- 421.2 cc, P = 0.007; and 8.7 +/- 3.6 vs. 15.3 +/- 8.7 days, P = 0.0001, respectively). No operative deaths occurred in either group.
  
  
  CONCLUSIONS
  Although LH does have a steep learning curve, we believe that it can be standardized and provide a less invasive surgical option--with no reduction in disease curability--for the treatment of liver tumors in selected patients.
authors: Division of General and Gastroenterological Surgery, Department of Surgery (Omori), Toho University School of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan. yotsuka@wa2.so-net.ne.jp
authors: Yuichiro
authors: Y
authors: Otsuka
authors: Masaru
authors: M
authors: Tsuchiya
authors: Tetsuya
authors: T
authors: Maeda
authors: Toshio
authors: T
authors: Katagiri
authors: Jun
authors: J
authors: Isii
authors: Akira
authors: A
authors: Tamura
authors: Kunihiro
authors: K
authors: Yamazaki
authors: Yoshihisa
authors: Y
authors: Kubota
authors: Takashi
authors: T
authors: Suzuki
authors: Takayuki
authors: T
authors: Suzuki
authors: Satoru
authors: S
authors: Kagami
authors: Hironori
authors: H
authors: Kaneko
mesh_terms: D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000592:standards*; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000592:standards*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications