title: Laparoscopic resection of hepatocellular carcinoma: when, why, and how? A single-center experience.
abstract: OBJECTIVE
  The aim of this study was to evaluate short- and intermediate-term results of laparoscopic liver resection in selected patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  Eighty-five patients with HCC were subjected to liver resection between February 2007 and January 2013. From these, 30 (35.2%) were subjected to laparoscopic liver resection and were retrospectively analyzed. Special emphasis was given to the indication criteria and to surgical results.
  
  
  RESULTS
  There were 21 males and 9 females with a mean age of 57.4 years. Patients were subjected to 10 nonanatomic and 20 anatomic resections. Two patients were subjected to hand-assisted procedures (right posterior sectionectomies); all other patients were subjected to totally laparoscopic procedures. Conversion to open surgery was necessary in 4 patients (13.3%). Postoperative complications were observed in 12 patients (40%), and the mortality rate was 3.3%. Mean overall survival was 29.8 months, with 3-year overall and disease-free survival rates of 76% and 58%, respectively.
  
  
  CONCLUSIONS
  Laparoscopic treatment of selected patients with HCC is safe and feasible and can lead to good short- and intermediate-term results.
authors.affiliation: Liver Surgery Unit, Department of Gastroenterology, University of São Paulo Medical School , São Paulo, Brazil .
authors.forename: Paulo
authors.initials: P
authors.lastname: Herman
authors.forename: Marcos Vinicius
authors.initials: MV
authors.lastname: Perini
authors.forename: Fabricio Ferreira
authors.initials: FF
authors.lastname: Coelho
authors.forename: Jaime Arthur Pirolla
authors.initials: JA
authors.lastname: Kruger
authors.forename: Renato Micelli
authors.initials: RM
authors.lastname: Lupinacci
authors.forename: Gilton Marques
authors.initials: GM
authors.lastname: Fonseca
authors.forename: Felipe de Lucena Moreira
authors.initials: Fde L
authors.lastname: Lopes
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D061887:Conversion to Open Surgery; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000379:methods* / Q000592:standards; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000592:standards; D007902:Length of Stay; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D010166:Palliative Care / Q000379:methods; D018579:Patient Selection; D011183:Postoperative Complications; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome