title: Comparison of laparoscopic liver resection for hepatocellular carcinoma located in the posterosuperior segments or anterolateral segments: A case-matched analysis.
abstract: Laparoscopic liver resection is an attractive option for treating liver tumors. Laparoscopic liver resection is more difficult for hepatocellular carcinomas located in the posterosuperior segments than for hepatocellular carcinomas in the anterolateral segments. We compared perioperative and long-term outcomes between laparoscopic liver resection for hepatocellular carcinomas located in the posterosuperior and anterolateral segments.
  
  
  
  We retrospectively reviewed the clinical data for 230 patients who underwent laparoscopic liver resection for hepatocellular carcinomas between September 2003 and July 2014. Of these, 116 patients were selected by case-matched analysis using age, sex, tumor number and size, Child-Pugh class, and extent of liver resection. Patients were classified into 2 groups according to tumor location: the anterolateral group (n = 58) and the posterosuperior group (n = 58).
  
  
  
  Operation time (355 minutes vs 212 minutes, P < .005), intraoperative blood loss (600 mL vs 410 mL, P < .001), and hospital stay (8.5 days vs 7 days, P = .040) were significantly greater in the posterosuperior group than in the anterolateral group. The open conversion (13.8% vs 10.3%, P = .777), postoperative complication (17.2% vs 10.3%, P = .420), 5-year overall survival (88.5% vs 85.7%, P = .370), and 5-year, recurrence-free survival (47.6% vs 40.9%, P = .678) rates were not significantly different between the posterosuperior and anterolateral groups.
  
  
  
  Although laparoscopic liver resection is more difficult for hepatocellular carcinomas located in the posterosuperior segment, there were no differences in the short- and long-term outcomes between the posterosuperior and anterolateral groups. The perceived impact of tumor location on patient outcomes could be overcome by experience and technical improvements.
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea.
authors.forename: Woohyung
authors.initials: W
authors.lastname: Lee
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea. Electronic address: hanhs@snubh.org.
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea.
authors.forename: Yoo-Seok
authors.initials: YS
authors.lastname: Yoon
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea.
authors.forename: Jai Young
authors.initials: JY
authors.lastname: Cho
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea.
authors.forename: YoungRok
authors.initials: Y
authors.lastname: Choi
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea.
authors.forename: Hong Kyung
authors.initials: HK
authors.lastname: Shin
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea.
authors.forename: Jae Yool
authors.initials: JY
authors.lastname: Jang
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea.
authors.forename: Hanlim
authors.initials: H
authors.lastname: Choi
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea.
authors.forename: Jae Seong
authors.initials: JS
authors.lastname: Jang
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea.
authors.forename: Seong Uk
authors.initials: SU
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000379:methods / Q000401:mortality; D007902:Length of Stay; D008099:Liver / Q000033:anatomy & histology* / Q000601:surgery; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D061646:Operative Time; D011379:Prognosis; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome