title: Laparoscopic left lateral hepatectomy for colorectal metastasis is the standard of care.
abstract: OBJECTIVE
  Over the last decade, laparoscopic liver surgery has significantly evolved. The aim of this study was to analyse the outcomes of Laparoscopic Left Lateral Hepatectomy (LLLH) for colorectal cancer (CRC) metastases in a tertiary referral hepato-pancreato-biliary centre.
  
  
  METHODS
  A consecutive series of patients undergoing LLLH between January 2009 and April 2013 were analysed using prospectively collected data in a tertiary referral HPB centre. In particular, the study focused on patients who had LLLH for colorectal liver metastasis (CRLM). The following features were analysed: operative time, intraoperative blood loss, number and size of tumours, resection margins, complication rates, follow up period and recurrence rates.
  
  
  RESULTS
  A total of 17 patients were finally included. There were no bile leaks or collections and no postoperative bleeding. The median hospital stay was 4 days (range 2-10). The median size of the metastatic lesions was 28.1 mm (range 8-56). The resection was R0 in all except 2 patients (11%) where the margin was less than 1 mm. The mean resection margin was 14.6 mm (range 1-50). Eight patients (47%) did not develop any recurrence till latest follow up. Seven patients (41%) developed recurrence in the liver or lungs. The median time to recurrence was 11 months (range 2-12). There was only one death in the follow up period (22-77 months). Sixteen patients (94%) were alive at the latest follow up.
  
  
  CONCLUSIONS
  LLLH for CRLM is safe and can be performed with low complication rates, adequate resection margins, short hospital stay, and oncologic outcomes similar to those of open surgery.
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery & Liver Transplantation, Royal Free Hospital, London, UK.
authors.forename: Samir J
authors.initials: SJ
authors.lastname: Sahay
authors.forename: Federico
authors.initials: F
authors.lastname: Fazio
authors.forename: Francesco
authors.initials: F
authors.lastname: Cetta
authors.forename: Hende
authors.initials: H
authors.lastname: Chouial
authors.forename: Panagis M
authors.initials: PM
authors.lastname: Lykoudis
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Fusai
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D059039:Standard of Care