title: Feasibility of laparoscopic liver resection for caudate lobe: technical strategy and comparative analysis with anteroinferior and posterosuperior segments.
abstract: Although laparoscopic liver resection (LLR) is now considered a standard procedure in peripheral segments, there are few reports on laparoscopic segment 1 (Sg1) resection. The aim of this study was to assess both safety and feasibility of Sg1 LLR.
  
  
  
  From 2000 to 2014, all patients who underwent LLR were identified from a prospective database. Patients with resection of Sg1 (Sg1 group) were compared with those with resection of anteroinferior segments (AI group: segments 3, 4b, 5, 6) or posterosuperior segments (PS group: segments 4a, 7, 8), in terms of tumor characteristics, surgical treatment, and short-term outcomes.
  
  
  
  There were 15, 151, and 67 patients in Sg1, AI, and PS groups. Tumor size and tumor number were similar between the three groups (p = 0.139, p = 0.102). Operative time was significantly shorter in Sg1 (150 min) and AI group (135 min) compared with PS group (180 min) (p = 0.021). Median blood loss was notably higher in PS group (140 ml) compared with Sg1 group (75 ml) and AI group (10 ml) (p = 0.001). No mortality was observed in all groups. Postoperative complication rate was 20.0 % with Sg1 group, 14.6 % with AI group, and 20.9 % with PS group (p = 0.060). The rate of major complication was significantly higher in Sg1 group (13.3 %) and PS group (11.9 %) compared with AI group (4.0 %) (p = 0.042). Resection margins were clear in all Sg1 and PS group patients, whereas two (1.3 %) patients in AI group had R1 margins (p = 0.586).
  
  
  
  The laparoscopic approach of isolated resection located in the caudate lobe is a feasible and curative surgical option in selected patients.
authors.affiliation: Department of Digestive Diseases, Institut Mutualiste Montsouris, Paris Descartes University, 42 Boulevard Jourdan, 75014, Paris, France.|Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Araki
authors.affiliation: Department of Digestive Diseases, Institut Mutualiste Montsouris, Paris Descartes University, 42 Boulevard Jourdan, 75014, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Fuks
authors.affiliation: Department of Digestive Diseases, Institut Mutualiste Montsouris, Paris Descartes University, 42 Boulevard Jourdan, 75014, Paris, France.|Department of Surgery, Nara Medical University, Nara, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nomi
authors.affiliation: Department of Digestive Diseases, Institut Mutualiste Montsouris, Paris Descartes University, 42 Boulevard Jourdan, 75014, Paris, France.|Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ogiso
authors.affiliation: Department of Digestive Diseases, Institut Mutualiste Montsouris, Paris Descartes University, 42 Boulevard Jourdan, 75014, Paris, France.
authors.forename: Ruben R
authors.initials: RR
authors.lastname: Lozano
authors.affiliation: Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
authors.affiliation: Department of Digestive Diseases, Institut Mutualiste Montsouris, Paris Descartes University, 42 Boulevard Jourdan, 75014, Paris, France. brice.gayet@imm.fr.
authors.forename: Brice
authors.initials: B
authors.lastname: Gayet
mesh_terms: D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies
keywords: Anteroinferior lesion; Caudal approach; Caudate lobe; Laparoscopic liver resection; Posterosuperior lesion
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