title: Outcomes of laparoscopic right posterior sectionectomy in patients with hepatocellular carcinoma in the era of laparoscopic surgery.
abstract: BACKGROUND
  Although there are very few reports of laparoscopic right posterior sectionectomy (RPS), we believe this is a promising operative method for lesions confined to the right posterior section of the liver.
  
  
  METHODS
  Between September 2003 and June 2012, laparoscopic liver resection was performed in 408 patients at Seoul National University Bundang Hospital. We analyzed the clinical data of 24 patients who underwent laparoscopic RPS for hepatocellular carcinoma (HCC) and compared outcomes with patients who underwent open RPS (n = 19).
  
  
  RESULTS
  The mean operation time was 567 minutes, and the mean postoperative hospital stay was 10.6 ± 4.8 days. The mean tumor-free margin was 3.0 ± 5.8 cm. There were no deaths or major complications. Two complications occurred, which were managed by percutaneous drainage. There were three conversions to laparotomy because of an insufficient tumor margin. These patients were treated when we had limited experience of laparoscopic resection. Extended RPS (n = 6), which involved RPS and resection of the right hepatic vein, was performed to achieve an adequate margin if the tumor was located very close to the right hepatic vein. The mean operation time was longer in laparoscopy group than that in open group (P < .001), but there was no difference in the mean resection margin (P = .450) and the rate of postoperative complications (P = .380) between 2 groups. There was no statistical difference in 5-year overall patient survival rate (79.1% vs 77.7%; P = .754) and the 5-year disease-free survival rate (42.2% vs 51.5%; P = .752) between the 2 groups.
  
  
  CONCLUSIONS
  Laparoscopic RPS is feasible when performed by experienced surgeons, but further refinements of the surgical technique are needed to reduce operation time.
authors: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Jai Young
authors: JY
authors: Cho
authors: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: hanhs@snubh.org.
authors: Ho-Seong
authors: HS
authors: Han
authors: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Yoo-Seok
authors: YS
authors: Yoon
authors: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: YoungRok
authors: Y
authors: Choi
authors: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Woohyung
authors: W
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome