title: Laparoscopic approach for treatment of multiple hepatocellular carcinomas.
abstract: BACKGROUND
  The aim of this study is to evaluate clinical and oncologic outcomes after laparoscopic surgery for patients with multiple hepatocellular carcinoma (HCC).
  
  
  METHODS
  Among the 260 patients who underwent laparoscopic procedures, including laparoscopic liver resection and laparoscopic radiofrequency ablation (LRFA), between September 2003 and December 2009, 107 patients with HCC were included in this retrospective study. According to tumor multiplicity, patients were divided into multiple lesion (n = 23) and single lesion (n = 84) groups. We compared the operative outcomes after the laparoscopic procedures between the single and multiple tumor groups.
  
  
  RESULTS
  There was no difference in the clinicopathologic characteristics between the two groups, except the multiple group had more frequent previous history of preoperative transarterial chemoembolization. LRFA was more frequently used in the multiple group as compared with the single group. There was no postoperative mortality in either group. Application of laparoscopic surgery in the multiple group did not increase the operative time, rate of intraoperative transfusion, length of postoperative hospital stay, or postoperative complications, as compared with the single group. After median follow-up of 33.7 months, there was no statistically significant difference of the survival rates between the two groups, although there was a better disease-free survival rate in the single group.
  
  
  CONCLUSIONS
  This study shows that laparoscopic surgery, including LH and LRFA, can be safely applied to patients with multiple HCCs, and the survival outcomes are acceptable.
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea. yoonys@snubh.org
authors.forename: Yoo-Seok
authors.initials: YS
authors.lastname: Yoon
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.forename: Jai Young
authors.initials: JY
authors.lastname: Cho
authors.forename: Chang Jin
authors.initials: CJ
authors.lastname: Yoon
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Kim
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies