title: [Clinical evaluation of laparoscopic hepatectomy for liver tumors in Couinaud Ⅰ, Ⅳa, Ⅶ, and Ⅷ].
abstract: OBJECTIVE
  To summarize the clinical experience of laparoscopic hepatectomy (LH) for liver tumors in Couinaud Ⅰ, Ⅳa, Ⅶ, and Ⅷ segment.
  
  
  METHODS
  Fifty-six patients with tumor in Couinaud Ⅰ, Ⅳa, Ⅶ, or Ⅷ segment underwent LH in Department of Hepatobiliary Surgery, the First Affiliated Hospital of Fujian Medical University from July 2009 to December 2014.The pathological diagnoses were hepatic hemangioma(5 patients), colorectal cancer metastasis to the liver(4 patients), hepatic adenoma (6 patients), hepatocellular carcinoma(32 patients), focal nodular hyperplasia(8 patients) and liver harmatoma(1 patient). The liver function of all patients was Child-Pugh class A. All patients were followed up by several kinds of methods which included outpatient or inpatient review, telephone and mail until January 2015.
  
  
  RESULTS
  LH was converted to open hepatectomy in one patient, and tumor resection by LH was successful in other patients.The mean diameter of tumor was (5.7±3.4)cm (range 3-9 cm). The mean operative time was (115±46)min (range 55-260 min). And the mean estimated intraoperative blood loss was (181±135)ml (range 20-550 ml). The postoperative hospital stay was (7.1±1.5)days (range 5-10 days). Postoperative complications occurred in 4 patients(7.1 percent) and resolved with conservative management. There was no perioperative deaths. At the 1-month follow-up, 47 patients had returned to full-time work. A total of 9 patients had evidence of recurrence after operation. The one-year overall and disease-free survival rates of patients with malignant tumor were 100 percents and 87.5 percents, respectively.
  
  
  CONCLUSIONS
  LH for tumors in segment Ⅰ, Ⅳa, Ⅶ, and Ⅷ is safe and effective.
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.forename: Kecan
authors.initials: K
authors.lastname: Lin
authors.forename: Jingfeng
authors.initials: J
authors.lastname: Liu
authors.forename: Yongyi
authors.initials: Y
authors.lastname: Zeng
mesh_terms: D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D018572:Disease-Free Survival; D020518:Focal Nodular Hyperplasia / Q000601:surgery; D006391:Hemangioma / Q000601:surgery; D006498:Hepatectomy; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008113:Liver Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D061646:Operative Time; D011183:Postoperative Complications; D011184:Postoperative Period; D016896:Treatment Outcome