title: Laparoscopic parenchymal preserving hepatic resections in semiprone position for tumors located in the posterosuperior segments.
abstract: BACKGROUND
  All patients who underwent laparoscopic liver resections in the posterosuperior segments (LPSS) at our center were positioned in semiprone since August 2011. The aims of this study were to assess differences in perioperative outcomes between laparoscopic left lateral sectionectomies (LLLS) performed in supine position and LPSS in semiprone position.
  
  
  METHODS
  We reviewed our prospectively collected database of all liver resections performed between January 2012 and January 2015. LLLS and LPSS were compared with respect to demographics and perioperative outcomes.
  
  
  RESULTS
  Forty-five patients underwent LLLS (n = 20) or LPSS (n = 25). There were no differences in patient demographics or tumor diameter (p = 0.946). There were no conversions. Pringle maneuver was not used in both groups. There was no difference in peroperative central venous pressure (p = 0.511). The median operative time in the LLLS group was 100 min (60-260) and 160 min (95-270) in the LPSS group (p = 0.002) with median intraoperative blood loss in the LLLS group of 50 ml (0-550) versus a larger 150 ml (50-700) (p = 0.010) for patients receiving LPSS. No patients required transfusion. Intraoperative and postoperative complication rates were similar in both groups. Median hospital stay was 6 days in both groups (p = 0.554).
  
  
  CONCLUSIONS
  LPSS in semiprone can be performed with similar clinical outcomes as a minor laparoscopic liver resection except for longer operative time and larger intraoperative blood loss without the need for transfusion.
authors.affiliation: Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium. mathieudhondt2000@yahoo.com.
authors.forename: Mathieu
authors.initials: M
authors.lastname: D'Hondt
authors.affiliation: Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium.
authors.forename: Emi
authors.initials: E
authors.lastname: Yoshihara
authors.affiliation: Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium.
authors.forename: Franky
authors.initials: F
authors.lastname: Vansteenkiste
authors.affiliation: Department of Anesthesia, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium.
authors.forename: Pieter Jan
authors.initials: PJ
authors.lastname: Steelant
authors.affiliation: Department of Anesthesia, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium.
authors.forename: Barbara
authors.initials: B
authors.lastname: Van Ooteghem
authors.affiliation: Interdisciplinary Research Center, Catholic University Leuven, Campus Kortrijk, Etienne Sabbelaan 53, 8500, Kortrijk, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Pottel
authors.affiliation: Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Devriendt
authors.affiliation: Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Van Rooy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D059351:Organ Sparing Treatments; D056888:Patient Positioning; D011183:Postoperative Complications / Q000453:epidemiology*; D016684:Prone Position; D012189:Retrospective Studies; D055815:Young Adult
keywords: Hepatectomy; Laparoscopic; Posterosuperior segments
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